CITY OF MANILA

UNIVERSIDAD DE MANILA
Formerly City College of Manila
One Mehan Gardens
Manila, Philippines 1000

COLLEGE OF HEALTH SCIENCES

DEPARTMENT OF NURSING

RELATED LEARNING EXPERIENCE

REMOVAL OF AN INDWELLING URINARY CATHETER

Name: _________________________ Grade: _____________

Section: ___________ Date: ______________

RATING QUANTITATIVE DESCRIPTION

5 Excellent
4 Competent
3 Satisfactory
2 Needs Improvement
1 Poor
Efficiently performs tasks without supervision
Performs tasks with minimal supervision
Performs tasks with moderate supervision
Performs tasks with constant supervision
Performs tasks with maximum supervision

Description: This is an evaluation tool designed to assess the competency level of nursing
students regarding various nursing skills.

Instruction: Check the appropriate box next to each indicator.

PROCEDURE 1 2 3 4 5
Assessment
1. Verify the order
2. Determine whether a urine specimen is needed.
Planning
3. Perform hand hygiene and observe infection control procedures.
4. Prepare supplies needed:
● Paper towel for wrapping the soiled catheter after removal.
● 10 ml syringe to remove the fluid from balloon.
● Padding and small container to catch the urine.
● Clean gloves
Implementation
5. Introduce yourself and identify the client
6. Explain the procedure to the client
7. Close the door or draw bed curtains, and position and drape the
patient.
8. Put on clean gloves
9. Withdraw the catheter
a. Place paper towels under the catheter.
b. Use syringe to remove the sterile water from the balloon.
c. Pinch the catheter and pull it out smoothly.
d. Wrap catheter in paper towel.
e. Hold the end of catheter up to allow urine to drain from the
tubing.
9. Assist the patient in comfortable position.
10. Measure urine output.
11. Dispose the equipment properly.
12. Remove gloves and perform hand hygiene
Evaluation
13. Evaluate using the following criteria:
 a. Catheter removed without difficulty
b. Patient voiding in adequate amount (250 mL) at regular
intervals.
c. Patient is continuing to increases fluid intake
14. Document the time the catheter was removed, the amount of urine
output and the patient’s response to the procedure.

Remarks:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
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Conforme:
_______________________ _______________________
Student Clinical Instructor