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Skills Lab 2
Catherization
| Question | Answer |
|---|---|
| 1 (1pt) | Checks chart for order |
| 2 (2pt) | Review policy and procedure |
| 3 (4pt) | State goals: (a) maintain sterility. (b) provide for urinary drainage. (c) relieve bladder distention. (d) provide means to obtain sterile specimen for urine C & S tests |
| 4 (1pt) | Gather equipment: (a) clean gloves for washing patient. (b) check expiration dates of caterization kit |
| 5 (1pt) | Provides privacy for patient |
| 6 (1pt) | Performs hand hygiene |
| 7 (1) (5pt) | Prepares patient: (a) identify 2 ways (1. wrist band & MR#/2. have pt. state name and DOB). (b) checks patient allergies |
| 7 (2) (5pt) | (c) Explains procedure to patient. (d) allow to verbalize questions. (e) establishes method of communication during the procedure |
| 8 (2pt) | Raise bed to working height, rails up on the opposite side |
| 9 (1) (6pt) | Perform urinary assessment: (a) when patient last voided. (b) presence of bladder distention |
| 9 (2) (6pt) | (c) incontinence. (d) history of prostate enlargement. (e) mobility/ physical limits |
| 10 (3pt) | Correctly positions patient and drapes accordingly: (a) Female-dorsal recumbent position with thighs externally rotated. (b) Male-supine with slighty abducted thighs. ***Provide support for legs if patient is unable to do so. |
| 11 (2pt) | Inspects perineal area for cleanliness and using clean gloves, washing area with soap and water PRN, and dry. Removes gloves and performs hand hygiene |
| 12 (2pt) | Opens cath and establishes sterile field |
| 13 (***) | DONS STERILE GLOVES CORRECTLY |
| 13 (4pt) | Applies sterile drape properly: (a) Female-under buttocks, absorbent side up. (b) Male-over thighs, below penis |
| 14 (2pt) | Organizes supplies |
| 15 (4pt) | (a) Female-sterile fenestrated drape over perineal area (optional). (b) Male-fenestrated drape over penis (required). ***Does not contaminate gloves |
| 16 (2pt) | Test balloon of indwelling catheter (some manufacturers do not encourage this) |
| 17 (2pt) | Lubricates tip of cath ((a)Female: 1-2" (b) Male: 5-7") If available in syringe , lubraicate can be injected directly into male urethra |
| 18 (2pt) | Opens antiseptic swab (if cotton balls present, pour antiseptic over balls) |
| Procedure:1 (Female) (1) (***) | Cleans urethral meatus properly: with nondominant, contaminated hand, retracts labia to expose urethral meatus, maintaining position of hand throughout procedure. Using dominant, sterile hand, pick up swabs... |
| Procedure:1 (Female) (2) (***) | ...cleanse perineal area wiping from front to back from clitoris to anus. Using a new antiseptic wipe, cleanse the far labial fold, near labial fold and directly over the urethral meatus |
| Procedure:1 (Male) (1) (***) | Cleans urethral meatus properly: if not circumsised, retract foreskin with nondominate, contaminated hand. Then grasps penis at shaft below glans. Retracts urethral meats between thumb and forefinger... |
| Procedure:1 (Male) (2) (***) | ...maintaining position of hand throughout procedure. Use dominant, sterile hand to pick up swabs. Cleanse in circular motion from urethral meatus down to base of glans. Repeats cleansing 3 more times, using new swab, each time |
| Procedure: 2 (3pt) | Discards used cotton swabs in prepared trash bag. Goes around sterile field each time with soiled material |
| Procedure: 3 (2pt) | Picks up cath with dominant sterile hand |
| Procedure: 4 (***) | MAINTAINS STERILITY OF FOLEY CATHETER AT ALL TIMES |
| Procedure: 5 (1) (5pt) | Inserts catheter: Female-asks patient to bear down as if voiding, inserts 2-3 inches. When urine appears, insert foley 1-2 more inches |
| Procedure: 5 (2) (5pt) | (b) Male-asks patient to bear down as if voiding, inserts to bi-furcation and balloon inflation port (or if urine return advance 1-2 inches further), with penis perpendicular to body, with light, upward traction. Ask patient to breathe deeply as needed |
| Procedure: 6 (1) (2pt) | Female-release labia and hold cath securely with nondominant, contaminated hand |
| Procedure: 6 (1) (2pt) | Male-lower penis, holds cath securely in nondominant contaminated hand |
| Procedure: 7 (4pt) | Inflates balloon of indwelling catheter according to balloon size. Verbalize if patient complains of sudden pain, to aspirate back solution immediately. (Give rationale) |
| Procedure: 8 (3pt) | Removes syringe leaving balloon inflated. Release catheter, pulling gently to check for resistance |
| Procedure: 9 (2pt) | (a) Female-secure tape to inner thigh. (b) Male-tape catheter to top of thigh or lower abdomen |
| Procedure: 10 (2pt) | Removes gloves correctly and performs hand hygiene |
| Procedure: 11 (2pt) | Places excess tubing on bed and attaches plastic clip to bottom sheet |
| Procedure: 12 (1pt) | Attach bag to bed frame |
| Procedure: 13 (1pt) | Removes supplies from the bed |
| Procedure: 14 (3pt) | Assess the urine and note its characteristics (amount, color, clarity) |
| Procedure: 15 (2pt) | Discards equipment according to agency procedure |
| Procedure: 16 (4pt) | Follow-up: (a) Start I&O, empty urinary drainage, Q8H (or by protocol) (b) keep free of kinks, excess tubing coiled on bed and clipped to sheet (c) keep taped to leg or lower abdomen (d) keep drainage bag below level of bladder (e) perform foley care Q8H |
| Procedure: 17 (4pt) | Education: keep bag below level of bladder. (b) do not kink or lie on top of tubing. (c) increase fluid intake to 2000-3000ml/day, unless contraindicated |
| Procedure: 18 (4pt) | Patient safety: (a) side rails up. (b) bed in lowest position. (c) call light within reach. (d) reposition patient. |
| Procedure: 19 (2pt) | Performs hand hygiene |
| Procedure: 20 (8pt) | Document: (a) date/time. (b) assessment date. (c) type & size of catheter used. (d) results (amount, clarity, color). (e) patient's tolerance. (f) patient teaching. (g) signature. |
Created by:
maggardba
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