URINARY CATHETERIZATION

by Justyann Brynn Sabio, BSN, RN (PHL,USA, CAN)

Urinary Catheterization is the introduction of a catheter

through the urethra into the bladder for the purpose of
withdrawing urine and drain the bladder.

Purposes

• To relieve urinary retention

• To obtain a sterile urine specimen
• To measure the amount of residual urine in the bladder
• To obtain a urine specimen when a specimen cannot
secure satisfactory by other means
• To empty bladder before and during surgery and before
certain diagnostic examinations
• To control urinary incontinence
• To provide access for instilling medication into the
bladder (through intravesical drug delivery)
• To monitor urine output

Equipment

1. Sterile catheterization pack which includes the following:

a.) Straight/Intermittent and/or Indwelling/Foley Catheter

(French 14-16 for female adults, French 8-10 for
children, French 18 & 20 for male adults but if this
appears too large, smaller catheter can be used
like French 14-16)
b.) Sterile fenestrated drape or eye sheet
c.) Lubricant
d.) Kidney basin/sterile basin
e.) Working forceps
f.) Betadine solution
g.) For Indwelling catheter: syringe with 5-10cc sterile
water, vial with sterile water, plaster & urine bag
h.) Sterile swabs
i.) Dry cotton balls
j.) 2-3 specimen bottles (for urine collection as ordered)
k.) Sterile drape

2. Sterile gloves
 Grading System

3 - Excellent
2 - Satisfactory
1 - Needs Improvement

Instructors: Kindly write 3,2, or 1 on the space provided and your

comments at the side (as needed).

Procedure for Insertion & Removal : Female & Male Straight/

Intermittent Catheterization

1.) Con rm/Verify health care provider’s order. ________

2.) Gather all supplies needed for the procedure. ________

3.) Perform hand hygiene and dry hands. ________

4.) Verify client/patient identi cation and explain

the procedure to be done. ________

5.) Determine if patient has any allergies ________

(especially to iodine and latex)

6.) Provide privacy. ________

7.) Set up good light source and place trash ________

receptacle within easy reach.

8.) Raise the bed to a comfortable working ________

height and maintain body mechanics.

9.) Provide perineal hygiene as needed ________

CLIENT/PATIENT WITH A VAGINA - Insertion and Removal

10.) Position patient in dorsal recumbent with

knees out then pull patient’s gown up to
expose the urinary meatus (opening of the
urethra). ________

11.) Open the catheterization pack by opening

the rst tab away from you then open side
tabs not touching the insides of the pack to
maintain sterility then the last tab. (DO NOT
touch equipment yet unless you have don
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 sterile gloves already except for the sterile
drape). ________

12.) Take the sterile drape and place it in

between upper thighs near the genital area. ________

13.) Don sterile gloves. ________

14.) Take the fenestrated drape/eye sheet

and place it over the vagina exposing only
the urinary meatus and vagina itself. ________

15.) Open swab sticks from its pack, check the

catheter for any damages or looks broken,
ready collection container for urine collection
as needed as ordered by hcp and open the
lubricant to lubricate the tip of the catheter. ________

16.) Lubricate catheter tip about 1 to 2 inches

and place it momentarily on the sterile
tray. ________

17.) Take 2-3 sterile swabs and put betadine

solution as needed (some swabs can be
used immediately without putting any
solution to cleanse the urinary meatus). ________

18.) Ready and place sterile basin, sterile swab sticks

and urine specimen container (as needed) on the
sterile drape near working area to facilitate
collection of urine by draining the bladder.
(Needs 2 sterile basins as needed to catch urine
if the volume is too much). ________

19.) Place non-dominant hand on the patient’s labia

and gently spread to expose the urinary meatus
then cleanse the urinary meatus using 2-3 swab sticks
one by one with downward stroke from front to back
then dispose by dropping it immediately (use dominant hand)
into the trash. (Once your non-dominant hand touches
the labia, remember that it is now considered unsterile.
You can now only use your dominant hand to
hold and insert the catheter.). ________

20.) Take the lubricated (tip) straight catheter from the

sterile tray using your dominant hand (sterile hand).
Hold catheter 3 inches from the tip and make sure
its distal end is inside the sterile basin to catch the
urine ow. _______
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 21.) Insert the catheter gently into the urethra until urine
ow is obtained by checking the distal end of the
catheter inside the sterile basin. While inserting the
catheter, instruct the patient to take a deep breath
and exhale or “bear down” as if to void. _______

22.) If hcp ordered to collect urine for urine culture

& sensitivity, put the distal end of the catheter
inside the specimen bottle and collect urine
midstream catch then put it back in the sterile
basin. _______

23.) Once urine has been completely drained into the

sterile basin, gently withdraw the catheter from
the urethra and discard into the trash receptacle. _______

24.) Measure urine output. Assess the color, smell,

and clearness of the urine as ordered by hcp. _______

25.) Discard urine in the toilet bowl and ush it. _______

26.) Remove gloves and discard properly into the trash

receptacle. Perform aftercare and clean up patient
then assist in comfortable position. _______

27.) Perform hand hygiene then document the

procedure and ndings. _______

CLIENT/PATIENT WITH A PENIS - Insertion & Removal

28.) Perform steps 1-9 then position patient in supine.

Pull gown up to expose the penis. Instruct patient
to spread legs. _______

29.) Grab the shaft of the penis and hold it in a 90-degree angle.
If there is a foreskin, pull the foreskin down. Take
sterile swabs (2-3) one by one then cleanse the tip &
head of the penis in a circular motion. _______
(using non-dominant hand)

30.) Insert the catheter (lubricated tip) gently

into the urethra (penis) and make sure that the distal end
of the catheter is in the sterile basin to catch urine
ow. Once urine starts to ow, continue until there
is stoppage in the ow. Once stopped, it means that
the bladder has been completely drained. While inserting
the catheter, instruct the patient to bear down as if to
void. _______
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 31.) Perform steps 22-27 including performing
hand hygiene then documenting procedure & ndings. ______

Procedure for Insertion & Removal : Female & Male

Indwelling/Foley Catheterization

CLIENT/PATIENT WITH A VAGINA - Insertion

32.) Perform steps 1-13 in straight catheterization. ________

33.) Withdraw 5-10cc of sterile water using a syringe

from the vial then remove catheter from
its plastic covering while keeping it in the sterile tray. _______

34.) In ate the balloon with the pre- lled syringe before
inserting the catheter to check for balloon patency.
Aspirate the uid back into the syringe when it is
determined that the balloon is patent. ________

35.) Perform steps 14-19 in straight catheterization. ________

36.) Pick up the catheter with your sterile dominant hand.

Instruct the patient to take a deep breath and
exhale or “bear down” as if to void, as you steadily
insert the catheter maintaining sterility of the catheter
until urine is noted. _______

37.) Once urine is noted, continue inserting

the catheter 2-3″ farther.” Do not force the catheter. _______

38.) With your dominant hand, in ate the retention balloon

with the water- lled syringe to the level indicated on
the balloon port of the catheter. With the plunger still pressed,
remove the syringe and set it aside. Pull back on the catheter
until resistance is met, con rming the balloon
is in place. _______

39.) Attach the urine drainage bag to the catheter and

avoid any kinks or loops. Secure the catheter
with securement device (plaster), allowing room
as to not pull on the catheter. _______

40.) Place the drainage bag below the level of the bladder,
attaching it to the bed frame. _______

41.) Remove gloves and discard properly into the trash

receptacle. Perform aftercare and clean up patient
then assist in comfortable position. ________
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 42.) Perform hand hygiene then document the
procedure and ndings. _______

CLIENT/PATIENT WITH A PENIS - Insertion

43.) Perform steps 1-9 then position patient in supine.

Pull gown up to expose the penis. Instruct patient
to spread legs. _______

44.) Perform steps 33 & 34. _______

45.) Grab the shaft of the penis and hold it in a 90-degree angle.
If there is a foreskin, pull the foreskin down. Take
sterile swabs (2-3) one by one then cleanse the tip &
head of the penis in a circular motion. _______
(using non-dominant hand)

46.) Pick up the catheter (lubricated) with your sterile dominant hand.
Instruct the patient to take a deep breath and exhale
or “bear down” as if to void, as you steadily insert
the catheter, maintaining sterility of the catheter,
until urine is noted in the tube. _______

47.) Once urine is noted, continue inserting to

the catheter bifurcation. _______

48.) With your non-dominant/non-sterile hand, continue

to hold the penis, and use your thumb and index nger
to stabilize the catheter. With the dominant hand, in ate
the retention balloon with the water- lled syringe to the
level indicated on the balloon port of the catheter. With
the plunger still pressed, remove the syringe and set it aside.
Pull back on the catheter slightly until resistance is met,
con rming the balloon is in place. ________

49.) Perform steps 39-42 including performing

hand hygiene then documenting procedure & ndings. ________

CLIENT/PATIENT WITH A VAGINA & PENIS - Removal

50.) Perform steps 1-8. ________

51.) Don clean gloves. ________

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 52.) Empty urine drainage bag into a container.
Measure urine output. Assess the color, smell,
and clearness of the urine as ordered by hcp. ________

53.) Discard urine in the toilet bowl and ush it then

remove & discard gloves. ________

54.) Don again another clean set of clean gloves and detach
the urine drainage bag from the catheter then discard. ________

55.) De ate the retention balloon before

attempting to remove the catheter using a syringe.
If in ated with10cc then must be able to withdraw
10cc also. _________

56.) Have the patient take several deep breaths to help

client relax while gently removing the catheter then
discard catheter into the trash receptacle. _________

57.) Clean the area thoroughly with antiseptic swabs

after the catheter is removed. _________

58.) Perform steps 26 & 27 including performing

hand hygiene then documenting procedure & ndings. ________

——————————————————————————————

GRADE: __________%

RAW SCORE: _______/174 X 60 + 40 = ________

Student’s Name: __________________________

Signature:_________________ Date:__________________

Clinical Instructor:__________________________

Signature:___________________

Overall comments during the procedure: (optional)

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