OUR LADY OF FATIMA UNIVERSITY

College of Nursing – Valenzuela

PROGRAM Bachelor of Science in Nursing STUDENT NAME

NCMA 113 YEAR AND SECTION
COURSE FUNDAMENTALS OF NURSING INSTRUCTOR
SKILLS LABORATORY DATE
PROCEDURE : FEMALE CATHETERIZATION
EXPECTED OUTCOME : The student should be able to demonstrate female catheterization correctly.
ASSESSMENT TASK : Return Demonstration
Exceptional Good Average Poor
Assessment Dimension SCORE
(3) (2) (1) (0)
1. Assess need for Performed the Performed but Performed with Failed to
catheterization. procedure accurately needs minimal slight difficulty, perform the
Refer client to the with evident ease supervision needs supervision procedure
doctor. without supervision most of the time
2. Verify doctor’s order Verified the doctor’s Verified the doctor’s Verified the Failed to verify
for catheterization order order with minimal doctor’s order the doctor’s
error incorrectly order
3. Prepare materials Gathered the materials Gathered the Gathered Failed to
needed completely materials with little materials with gathered all the
time preparation more time materials
preparation needed
4. Do handwashing Observed principle of Hand washing was Hand washing was Hand washing
medical hand washing done with minimal done with was not done
error maximal error
5. Identify client. Explained the Explained the Explained the Failed to explain
Explain procedure. procedure to the client procedure but lacks procedure but in the procedure
Provide privacy. and significant others details an unclear
clearly manner
6. Apply aseptic Demonstrated the Demonstrated the Demonstrated the Failed to
techniques during procedures with ease procedure with little procedure with perform the
the entire errors some errors procedure
procedure.
7. Open the Performed the Performed but Performed with Failed to
catheterization kit procedure accurately needs minimal slight difficulty, perform the
aseptically. with evident ease supervision needs supervision procedure
without supervision most of the time
8. Add materials to the Performed the Performed but Performed with Failed to
kit. Ensure sterility procedure accurately needs minimal slight difficulty, perform the
at all time. with evident ease supervision needs supervision procedure
without supervision most of the time

9. Position the client. Performed the Performed but Performed with Failed to
procedure accurately needs minimal slight difficulty, perform the
with evident ease supervision needs supervision procedure
without supervision most of the time

10. Wear first glove and Performed the Performed but Performed with Failed to
fill the syringe with procedure accurately needs minimal slight difficulty, perform the
distilled water. with evident ease supervision needs supervision procedure
without supervision most of the time
11. Wear second glove Performed the Performed but Performed with Failed to
and apply sterile procedure accurately needs minimal slight difficulty, perform the
drapes to the with evident ease supervision needs supervision procedure
patient. without supervision most of the time
12. Test the balloon of Demonstrated the Demonstrated the Demonstrated the Failed to
the catheter by procedures with ease procedure with little procedure with perform the
inflating it. errors some errors procedure
13. With non-dominant Performed the Performed but Performed with Failed to
hand separate the procedure accurately needs minimal slight difficulty, perform the
labia minora with with evident ease supervision needs supervision procedure
the thumb and without supervision most of the time
index finger. Never
remove fingers until
catheter is inserted.
14. With the dominant Performed the Performed but Performed with Failed to
 hand, use sterile procedure accurately needs minimal slight difficulty, perform the
forceps and pick up with evident ease supervision needs supervision procedure
swabs. Clean first without supervision most of the time
from the meatus
downward and then
on either side using
a new swab for each
stroke.
15. Pick up the catheter. Performed the Performed but Performed with Failed to
Place the drainage procedure accurately needs minimal slight difficulty, perform the
end of the catheter with evident ease supervision needs supervision procedure
in the urine without supervision most of the time
receptacle using
uncontaminated
hand.
16. Lubricate the Performed the Performed but Performed with Failed to
insertion end or tip procedure accurately needs minimal slight difficulty, perform the
of the catheter. with evident ease supervision needs supervision procedure
without supervision most of the time
17. Gently insert the Performed the Performed but Performed with Failed to
catheter in the procedure accurately needs minimal slight difficulty, perform the
direction of the with evident ease supervision needs supervision procedure
urethra until urine without supervision most of the time
flows.
18. Connect the Performed the Performed but Performed with Failed to
catheter to the procedure accurately needs minimal slight difficulty, perform the
urine bag. Ensure with evident ease supervision needs supervision procedure
that the emptying without supervision most of the time
base of the bag is
closed.
19. Inflate the balloon Performed the Performed but Performed with Failed to
by injecting 5 – 10 cc procedure accurately needs minimal slight difficulty, perform the
of distilled water. with evident ease supervision needs supervision procedure
Check the anchor. without supervision most of the time
20. Tape the catheter Performed the Performed but Performed with Failed to
with non-allergenic procedure accurately needs minimal slight difficulty, perform the
tape at the thigh of with evident ease supervision needs supervision procedure
the patient. without supervision most of the time
21. Remove drapes and Performed the Performed but Performed with Failed to
make patient procedure accurately needs minimal slight difficulty, perform the
comfortable. with evident ease supervision needs supervision procedure
without supervision most of the time
22. Dispose soiled Performed the Performed but Performed with Failed to
materials properly. procedure accurately needs minimal slight difficulty, perform the
with evident ease supervision needs supervision procedure
without supervision most of the time
23. Do handwashing Washed hands and Washed hands and Washed hands but Washed hands
and document documented the some of the details most of the but
procedure. information about the of procedure were details of the documentation
procedure properly not documented. procedure were was not done.
and completely. not documented

OVERALL SCORE: ________________

Target raw score 52 out of 69. If raw score is less than 52, repeat the demonstration.

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FACULTY SIGNATURE OVER PRINTED NAME