TAGUM DOCTORS COLLEGE

COLLEGE OF NURSING

PERFORMANCE CHECKLIST
FEMALE CATHETERIZATION

Name: _____________________________________ Grade: ____________

Year: ______________________________________ Date: _____________

Legend: 5 - Excellent 4 - Very Good 3 - Good 2 - Fair 1 - Poor

RATING
5 4 3 2 1
1. Checks for doctor’s order
2. Assesses whether client is allergic to iodine or plaster
3. Check for completeness of supply
4. Washes hands. Assembles equipment
5. Identifies and explains the procedure to the client
6. Provide privacy
7. Replaces top sheet with a bath blanket. Places waterproof under pad
8. Positions the client on a dorsal recumbent with feet apart and drapes the
client
9. Provides good light
10. Does perineal flushing
11. Prepares the urine receptacle and tubing if an indwelling catheter is to be
inserted
12. With aseptic technique, opens the pack between the clients thigh and it
near the perineal area.
13. Squeezes a small amount of lubricant over the sterile OS
14. Gets 2 cotton balls with betadine from the jar and places it on the sterile
field
15. Puts on sterile gloves. Places fenestrated drape over the vulva area
exposing the labia.
16. Lubricates 1-2 inches of the catheter tip
17. With the thumb and forefinger of your non-dominant hand spread the
labia. With the dominant hand, disinfects the meatus twice using CB with
betadine.
18. Maintains, hold until after catheter has been inserted
19. Inserts the tip of the catheter into the dimple like structure just below the
clitoris about 2-3 inches or until urine flows. Asks the client to breathe deeply
as catheter is inserted.
20. Holds the catheter securely with the non-dominant hand while bladder is
emptied. Collects a specimen if required.
21. Remove the catheter smoothly and slowly (if straight catheter is used)
22. If a Foley catheter is used, introduces 5 cc of distilled water to secure the
catheter, gently pulls the catheter until retention balloon is snuggled against
the neck of the bladder. Tapes the catheter to the inner thigh.
23. Attaches catheter to the urinary bag below the level of the bladder.
24. Removes and cleans the equipment. Makes the client comfortable. Labels
the urine specimen and sends to the laboratory promptly.
25. Removes gloves and washes hands
26. Records the time of the catheterization, the amount of the urine removed,
a description of the urine, the clients reaction to the procedure

Remarks:
Clinical Instructor’s Signature:_____________________ Date signed:
______________

Student’s signature: _____________________________ Date signed: ______________