OSCE Checklist: Female Catheterisation
Introduction
1 Introduce yourself to the patient including your name and role
2 Confirm the patient's name and date of birth
3 Briefly explain what the procedure will involve using patient-friendly language
4 Explain the need for a chaperone
5 Gain consent to proceed with catheterisation
6 Check if the patient has any allergies
7 Ask the patient if they have any pain before continuing with the clinical procedure
8 Explain to the patient that they’ll need to remove their underwear and lie on the clinical
examination couch, covering themselves with the sheet provided
9 Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and
water
Gather equipment
10 Clean the top of a procedure trolley using an appropriate disinfectant wipe
11 Collect the equipment required for the procedure and place it within reach on the clean
trolley
12 Check the expiry date on the catheter, sterile water, normal saline and lidocaine gel
13 Ensure a clinical waste bin is placed nearby
Equipment preparation
14 Wash your hands again and don an apron
15 Setup up the sterile field by first removing the outer packaging from the catheter pack and
then opening the catheter pack from the corners without touching the inner surface of the
field. Make sure to keep the catheter packaging as you’ll need to transfer the sticky label
containing the details of the catheter into the patient’s notes.
16 Using aseptic non-touch technique (ANTT) empty the catheter, lidocaine gel syringe, sterile
water syringe and sterile gloves onto the field
17 Pour the 0.9% sodium chloride solution over the cotton balls which should already be
located within the gallipot of the catheter pack
Positioning the patient
18 With the patient lying supine, ensure the bed is at an appropriate height for you to
comfortably carry out the procedure
19 Wash your hands again and don a pair of sterile gloves
20 Ask your chaperone to remove the sheet covering the patient’s genitals to allow you to
maintain sterility
21 Place a sterile absorbent pad underneath the patient’s genital region, ensuring you maintain
sterility
Cleaning the genital region
22 Part the labia with your non-dominant hand
23 With your dominant hand pick up a cotton ball and use a single stroke moving downwards to
clean the urethral meatus and surrounding genital region. Dispose of the first cotton ball into
the clinical waste bin and continue to repeat this process with a new cotton ball each time
until the area has been thoroughly cleaned
24 Discard your used gloves, wash your hands again and don a new pair of sterile gloves
25 Place the sterile drape over the patient's genitals, positioned such that the genitals remain
visible through the central aperture of the drape. Some drapes come with a hole already
present for this purpose, whereas others will require you to create one
26 Place the sterile urine collection bowl below the genitals but on top of the sterile drape
Inserting the local anaesthetic
27 Warn the patient that the anaesthetic gel might initially sting, but then should quickly cause
things to become numb
28 Part the labia with your non-dominant hand
29 With your dominant hand place the nozzle of the syringe of anaesthetic gel into the urethral
meatus
30 Empty the entire 5mls of anaesthetic gel into the urethra at a slow but steady pace
31 Allow 3 to 5 minutes for the lidocaine gel to reach its maximum effect
Inserting the catheter
32 Pick up the catheter which should be on your sterile field in its wrapper
33 Remove the tear-away portion of the wrapper near the catheter tip, making sure not to touch
the catheter
34 Part the labia with your non-dominant 'dirty hand'
35 Warn the patient you are about to insert the catheter
36 Insert the exposed catheter tip into the urethral meatus using your dominant ‘clean hand’
37 Advance the catheter slowly whilst gradually removing more of the wrapper to expose more
of the catheter
38 You should continue to advance the catheter until it is fully inserted into the urethra
39 Once the catheter is fully inserted, inflate the catheter balloon with the 10ml syringe of
sterile water to secure it within the bladder
40 Once the balloon is fully inflated, remove the syringe and gently withdraw the catheter until
resistance is noted, confirming the catheter is held securely within the bladder
41 Attach the catheter bag tubing to the end of the catheter securely
42 Position the catheter bag below the level of the patient to facilitate effective drainage of
urine
43 Clean away any urine spillage or excess lubricating gel and cover the patient with the sheet
44 Dispose of your equipment into a clinical waste bin
45 Wash your hands
46 Provide the patient with privacy to get dressed
To complete the procedure…
47 Explain to the patient that the procedure is now complete and that they should seek review
if the catheter becomes painful or they feel unwell
48 Thank the patient for their time
49 Ask the nursing staff to monitor the patient’s urine output and to contact you if they have any
concerns
50 Document the details of the procedure in the patient’s notes and affix the sticky label from
the catheter packaging beside your notes
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