OSCE catheterisation protocol

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A detailed protocol on how to insert a catheter in an OSCE examination.

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OSCE catheterisation protocol

  1. 1. C. Riedinger 1Male Catheterisation notes MALE CATHETERISATION – 10 minTask: - 10 minute station - scenario: medical student inserting catheter into patient Mr X - act as if real patient - explain what you are doing to examinerProcedure: - introduce self, gain consent and co-operation - ensure privacy (close curtains or say you would) - put on apron - perform hand hygiene, roll up sleeves, remove wrist watch - say you would perform bladder scanning to ensure that the patient not in urinary retention - collect equipment: o lidocaine syringe o 2x STERILE gloves, best in two different sizes (putting on the 2nd pair will be harder as hands are sweaty) o water bag o catheter (male, i.e. the longer one) o catheter bag o catheter pack containing plastic tray, covering sheet, gauzes, .. - prepare equipment using sterile non-touch technique o clean trolley including legs o open up catheter pack o insert hand into bin bag and use it to place items on the sterile field o stick bin bag onto trolley o open seringes and other items and drop onto sterile field o when opening the catheter, check expiry date and keep the sticker with the label for later notekeeping (see alternatives later, no need to open catheter here, can also do it later) o pour the water from the bag into the tray - help the patient to get into the supine position - place absorbent pad underneath buttocks - perform hand hygiene again, put on 1st pair of sterile gloves - wet four pieces of gauze and make a sling of the fifth one - tear a hole in the sterile cloth contained in the catheter pack and place it over the patient’s penis - arrange towels so that only the penis is visible - explain to patient what you are about to do - pick up penis with sling - clean using a new swab for each quadrant of the penile head, wipe away from meatus, if necessary pull back foreskin - dispose of gauzes into the yellow binbag - prepare lidocaine syringe and insert into urethral orifice and slowly empty the syringe - say you will wait 2-3 minutes - remove 1st pair of sterile gloves, perform hand hygiene and put on 2nd pair of gloves
  2. 2. C. Riedinger 2Male Catheterisation notes - connect catheter with catheter bag (to main valve, not the little side-one) - then transfer to patient - insert the catheter until urine flows (say that), then push another 5cm to ensure it is in the bladder alternatively feed catheter straight out of the pack into penis alternatively pick up catheter using a sterile gauze - negotiates narrowing at the prostate bend by lifting up the penis towards the pubis while keeping it slightly stretched - inflate the balloon using a water-filled syringe (need to push quite a bit) - pull catheter back until resistance is felt - reposition the foreskin (say it) - attach catheter bad or leg drainage bad using sterile technique then tape catheter to inside of thigh - help to clean patient up and ask if they are comfortable - take urine sample if necessary - inform other members of staff of this procedure and any follow ups required - document details of procedures in notes: patient notes and catheterisation plan - leave clinical area tidy - perform hand hygiene again

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