Chinese General Hospital Colleges

Second Semester, Academic Year 2020 to 2021

N-109 MCN 2 RLE

Skills Checklist
Skill 1. Urinary Catheterization and Collection

Name: ______________________________ Section: __________ Date: __________

Check the corresponding box based on the following grading criteria:

3 – Activity performed correctly.
2 – Activity performed correctly but with supervision.
1 – Activity performed incorrectly.
0 – Activity not performed.

Activities 3 2 1 0 Remarks
1. Checks doctor’s order for the purpose of the procedure (urine
specimen collection, straight catheterization, or indwelling
catheterization).
2. Informs patient and explains the procedure.
3. Washes hands.
4. Prepares necessary equipment and supplies:
A. sterile urethral catheter (correct size and type), sterile or
clean kidney basin and enamel cup, sterile gloves, lubricant,
sterile gauze, betadine, cotton balls, sterile forceps or pick
up forceps soaked in sterile solution, bed protector, flash
light or floor lamp, clean tissue paper.
B. for specimen collection include sterile receptacle bottle.
C. for indwelling catheterization include: adhesive plaster, pair
of scissors, urinary drainage bag, sterile syringe with sterile
water.
5. Provides privacy. Closes bed curtains or room curtains.
6. Asks/assists patient to remove underwear or open diaper.
7. Positions patient:
A. female patient in dorsal recumbent position.
B. male patient in supine position.
8. Places bed protector under the perianal area.
9. Drapes patient:
A. female client: placed blanket in diamond fashion over client,
one corner at client’s neck, side corners over each side and
secured around each thigh, last corner over perineum.
B. male client: draped upper trunk with bath blanket and
covered lower extremities with bed sheets, exposing only
the genitalia.
10. Positions lamp to illuminate perineal area for female patients.
11. Unwraps the sterile pack being careful not to contaminate the
inner surface.
12. Prepares lubricant by dropping a few amount on the sterile
gauze or on the thumb side of the sterile glove of the
nondominant hand.
13. Puts on sterile gloves. (In the absence of a sterile forceps,
cleans the genitalia using the pickup forceps soaked in sterile
solution and cotton balls with betadine before putting on sterile
gloves.)
14. Attaches syringe and tests balloon by inflating then deflating
the balloon using sterile water.

N-109 MCN 2 RLE Skill 1: Urinary Catheterization and Collection

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 Activities 3 2 1 0 Remarks
15. Exposes the urinary meatus using the nondominant hand.
16. Cleans the area surrounding the meatus using cotton balls with
betadine held in sterile forceps (circular motion for males; rule
of seven for females). Uses one cotton ball per stroke and
discards used cotton balls away from the sterile field.
17. Lubricates the tip of the catheter being careful not to plug the
opening.
18. Instructs patient to bear down during initial insertion and to
breathe through the mouth while the catheter is being threaded
in.
19. Inserts the catheter 2-3 inches into females; 6-9 inches into
males holding the penis at a 45-degree angle until urine flow is
noted.
20. Performs the following:
A. For specimen collection: let a few cc passed out first on the
kidney basin, pinches catheter then drains required amount
of urine into sterile bottle. Re-pinches catheter then drains
remaining urine on the kidney basin.
B. For intermittent catheterization: drains urine continuously
on the kidney basin or enamel cup until bladder is relieved
of distention. May apply pressure over the lower abdomen.
C. For indwelling catheterization: inflates balloon and
connects tip of catheter to the hospicare bag. Secures
tubings and hospicare bag.
21. For removal of catheter:
A. Deflates the balloon (for indwelling catheter).
B. Pinches/folds the catheter.
C. Instructs the client to breathe through the mouth as catheter
is gently pulled out of the meatus.
D. Provides clean tissue paper to wipe the genital area.
E. Assists client to put on underwear or diaper.
22. Removes bed protector. Removes gloves.
23. Assists patient to comfortable position.
24. Discards disposable equipment. Cleanses nondisposable
equipment. Washes hands.
25. Documents the following: date, time, procedure done, purpose
of obtaining urine specimen (urinalysis, urine CS), amount,
characteristic of urine, size and type of catheter used.
Total Score (105)
Transmuted Grade

Student’s Signature: ____________________ Instructor’s Signature: ____________________

N-109 MCN 2 RLE Skill 1: Urinary Catheterization and Collection

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