PERFORMANCE CHECKLIST

CATHETER CARE

NOT
PROCEDURE DONE SCORE
DONE
1. Wash hands. 1

2. Inform the patient about the procedure. 3

3. Gather materials needed. 3

4. Provide privacy. 3

5. Check if the catheter is intact. 3

6. Clamp the mid portion of catheter. 3

7. Place bedpan. 3

8. Drain bag before removing from the urine bag. 3

9. Measure the urine output. 4

10. Wipe the catheter with cotton wet with distilled

3
water and dry cotton using several stroke from
proximal to distal.
11. From the clamped area, wipe the catheter several 3
times proximal to distal using alcohol.
12. Using cotton with betadine, wipe catheter from 3
urethra to the clamp.
13. Attach the new urine bag, remove clamp, check 3
for leaks.
14. Remove bedpan, then secure the catheter on the 3
thigh.
15. Do after care, ask if patient needs anything. 3

16. Do documentation. 3

TOTAL 50

Name: ____________________ Score: _______________

Section: ___________________ Date: _______________
Instructor:__________________