Bladder Catheterization checklist and grading tool

yes no comments
1 Wash hands with antiseptic soap for at least 30 seconds OR
use alcohol based rub for 15 seconds, allowing it to dry

2 Perform Time out
Check patients name

3 Verify all equipment is available
-prepackaged Foley catheter tray
-a drainage bag
-catheter of choice

4 Verify that patient is in correct position
-males are supine
-females are supine with knees flexed wide and heels
together for adequate exposure of meatus
Verbalize the position in the awake patient

5 Open sterile portion of catheter tray
Put on sterile gloves
Prepare materials before insertion of catheter
Open the prep solution and soak applicator cotton balls
Apply the sterile drapes

6 Inflate and deflate Foley balloon with 5-10 cc sterile water
to ensure proper function
Coat the end of the Foley catheter with sufficient lubricant
jelly

7 For females use one gloved (non dominant) hand to prep
urethra in pubic to anus motion; separate labia with other
gloved hand
For uncircumcised males retract foreskin and hold penis in
upright position; use other gloved hand to prep urethra in
circular motion

8 Use gloved hand to insert Foley catheter with gentle but
steady pressure; encourage patient to take slow deep breaths
and not to bear down
Place catheter to the hilt of the drainage end of Foley
catheter

9 Inflate Foley balloon with 5-10 cc sterile water
10 Pull Foley catheter back to desired length until feel
resistance from balloon

11 Connect Foley catheter to drainage bag
12 Secure drainage bag to leg
13 Dispose of equipment safely
Total points (out of 11)



Indications: relief of urinary retention, collection of sterile urine specimen, monitoring of urinary output
accurately, performance of formal bladder examinations (VCUG, cystogram)

Contraindications: urethral disruption with pelvic fracture (be suspicious of blood at meatus, perineal
ecchymosis, high riding boggy prostate, pelvic hematoma), acute prostatitis