<p> Skill Check-Off Competency:</p><p>Urethral Catheterization of a Male</p><p>Acceptable OR Step Action Unacceptable (A/U) Determines bladder Assessment distention Determines any limiting conditions of patient Determines patient knowledge of purpose and procedure and provides instruction as needed Gathers appropriate Equipment equipment for procedure and clears bedside table Appropriate hand washing Hand hygiene before touching patient Verbalizes or performs room Privacy privacy intervention Raises bed to appropriate Safety height, lowers side rail on working side Supine, legs slightly Positioning abducted Properly drapes patient Draping without risk of contamination by blankets/sheet Opening Package Opens catheter kit using sterile technique Sterile Glove Correctly dons sterile gloves Prepares antiseptic cleaning Set-up swabs Checks balloon integrity (if using foley catheter) Lubricates catheter Sterile Drape Maintains sterility while * this may be done before placing sterile drape under/on donning sterile gloves as long as 1” edge barrier is patient maintained Adequately places sterile tray Sterile tray in accessible area for placement procedure while maintaining sterile field Swabs x3 in circular motion Antiseptic from urethra to base of glans, Cleansing nondominant hand remains in place holding shaft of penis Verbalizes approximate Insertion insertion distance for males and signs of proper insertion Verbalizes what to do in case Trouble shooting of: Resistance with insertion in male Inserts appropriate amount of Balloon Inflation fluid Properly secures catheter to Securing patient Places drainage bag below Bag placement level of bladder, NOT on side rail Changes chux pad, cleans Cleaning and excess antiseptic off patient, positioning patient positions patient for comfort Recording Type and size of catheter How inserted (sterile technique) Amount of fluid in balloon Description and amount of urine return upon insertion Reason for catheterization Patient’s response Skill Performance (circle one): PASS FAIL</p><p>Instructor’s initials and date: ______</p><p>Student’s initials: ______</p><p>*Automatic failure if sterile technique is broken and not caught by student</p><p>*More than 3 unacceptable actions results in failure of skill</p><p>*If student catches break in sterile field, they must be able to verbalize required intervention necessary to continue catheter insertion</p>