Name Date
Group Year Level
Instructor/Evaluator: Grade
SKILL 12-7
Catheterizing the Male Urinary
Needs Practice
Bladder
Satisfactory
Excellent
Goal:The patient’s urinary elimination is maintained, with
a urine output of at least 30 mL/hour, and the patient’s
bladder is not distended. Comments
1. Review chart for any limitations in physical activity. Con-
firm the medical order for indwelling catheter insertion.
2. Bring catheter kit and other necessary equipment to the
bedside. Obtain assistance from another staff member, if
necessary.
3. Perform hand hygiene and put on PPE, if indicated.
4. Identify the patient.
5. Close curtains around bed and close the door to the room,
if possible. Discuss the procedure with the patient and
assess patient’s ability to assist with the procedure. Ask the
patient if he has any allergies, especially to latex or iodine.
6. Provide good lighting. Artificial light is recommended (use
of a flashlight requires an assistant to hold and position it).
Place a trash receptacle within easy reach.
7. Adjust the bed to a comfortable working height, usually
elbow height of the caregiver (VISN 8 Patient Safety Cen-
ter, 2009). Stand on the patient’s right side if you are right-
handed, patient’s left side if you are left-handed.
8. Position the patient on his back with thighs slightly apart.
Drape the patient so that only the area around the penis is
exposed. Slide waterproof pad under patient.
9. Put on clean gloves. Clean the genital area with washcloth,
skin cleanser, and warm water. Clean the tip of the penis
first, moving the washcloth in a circular motion from the
meatus outward. Wash the shaft of the penis using down-
ward strokes toward the pubic area. Rinse and dry.
Remove gloves. Perform hand hygiene again.
10. Prepare urine drainage setup if a separate urine collection
system is to be used. Secure to bed frame according to
manufacturer’s directions.
11. Open sterile catheterization tray on a clean overbed table,
using sterile technique.
12. Put on sterile gloves. Open sterile drape and place on
patient’s thighs. Place fenestrated drape with opening
over penis.
SKILL 12-7
Catheterizing the Male Urinary Bladder
Needs Practice
(Continued)
Satisfactory
Excellent
Comments
13. Place catheter set on or next to patient’s legs on sterile
drape.
14. Open all the supplies. Fluff cotton balls in tray before
pouring antiseptic solution over them. Alternately, open
package of antiseptic swabs. Open specimen container if
specimen is to be obtained. Remove cap from syringe pre-
filled with lubricant.
15. Place drainage end of catheter in receptacle. If the catheter
is preattached to sterile tubing and drainage container
(closed drainage system), position catheter and setup
within easy reach on sterile field. Ensure that clamp on
drainage bag is closed.
16. Lift penis with nondominant hand. Retract foreskin in
uncircumcised patient. Be prepared to keep this hand in
this position until catheter is inserted and urine is
flowing well and continuously. Using the dominant hand
and the forceps, pick up a cotton ball or antiseptic swab.
Using a circular motion, clean the penis, moving from the
meatus down the glans of the penis. Repeat this cleansing
motion two more times, using a new cotton ball/swab
each time. Discard each cotton ball/swab after one use.
17. Hold penis with slight upward tension and perpendicular
to patient’s body. Use the dominant hand to pick up
the lubricant syringe. Gently insert tip of syringe with
lubricant into urethra and instill the 10 mL of lubricant
(Society of Urologic Nurses and Associates, 2005c).
18. Use the dominant hand to pick up the catheter and hold it
an inch or two from the tip. Ask the patient to bear down
as if voiding. Insert catheter tip into meatus. Ask the
patient to take deep breaths. Advance the catheter to the
bifurcation or “Y” level of the ports. Do not use force to
introduce the catheter.If the catheter resists entry, ask
patient to breathe deeply and rotate catheter slightly.
19. Hold the catheter securely at the meatus with your
nondom- inant hand. Use your dominant hand to inflate the
catheter balloon. Inject the entire volume of sterile water
supplied
in the prefilled syringe. Once the balloon is inflated,
the catheter may be gently pulled back into place.
Replace foreskin over catheter.Lower penis.
20. Pull gently on catheter after balloon is inflated to feel
resistance.
21. Attach catheter to drainage system, if necessary.
SKILL 12-7
Catheterizing the Male Urinary Bladder
Needs Practice
(Continued)
Satisfactory
Excellent
Comments
22. Remove equipment and dispose of it according to facility
policy. Discard syringe in sharps container. Wash and dry
the perineal area as needed.
23. Remove gloves. Secure catheter tubing to the patient’s
inner thigh or lower abdomen (with the penis directed
toward the patient’s chest) with Velcro leg strap or tape.
Leave some slack in catheter for leg movement.
24. Assist the patient to a comfortable position. Cover the
patient with bed linens. Place the bed in the lowest
position.
25. Secure drainage bag below the level of the bladder. Check
that drainage tubing is not kinked and that movement of
side rails does not interfere with catheter or drainage bag.
26. Put on clean gloves. Obtain urine specimen immediately, if
needed, from drainage bag. Label specimen. Send urine
specimen to the laboratory promptly or refrigerate it.
27. Remove gloves and additional PPE, if used. Perform hand
hygiene.
