Male patients confined to bed usually prefer to use the urinal for voiding. The use of a urinal in the standing position facilitates emptying of the bladder If the patient is unable to stand, the urinal may be used in bed. Patients may also use a urinal in the bathroom to facilitate measurement of urinary output. Provide skin care and perineal hygiene after urinal use and maintain a professional manner EQUIPMENT Urinal with end cover (usually attached) Toilet tissue Clean gloves Additional PPE, as indicated ASSESSMENT Assess the patient’s normal elimination habits. Determine why the patient needs to use a urinal, such as a physician’s order for strict bed rest or immobilization. Assess the patient’s degree of limitation and ability to help with activity Assess for activity limitations, such as hip surgery or spinal injury, which would contraindicate certain actions by the patient. Check for the presence of drains, dressings, intravenous fluid infusion sites/equipment, traction, or any other devices that could interfere with the patient’s ability to help with the procedure or that could become dislodged. Assess the characteristics of the urine and the patient’s skin. Document the patient’s tolerance of the activity. Record the amount of urine voided on the intake and output record, if appropriate. Document any other assessments, such as unusual urine characteristics or alterations in the patient’s skin. SPECIAL CONSIDERATION Urinal should not be left in place for extended periods because pressure and irritation to the patient’s skin can result. If patient is unable to use alone or with assistance, consider other interventions, such as commode or external condom catheter. It may be necessary to assist patients who have difficulty holding the urinal in place, such as those with limited upper extremity movement or alteration in mentation, to prevent spillage of urine. The urinal may also be used standing or sitting at the bedside or in the patient’s bathroom, if patient is able to do so.

6. ACTION RATIONALE
1. Review the patient’s chart for any
limitations in physical activity.
Activity limitations may contraindicate
certain actions by the patient.
2. Bring urinal and other necessary
equipment to the bedside stand or
overbed table.
Bringing everything to the bedside
conserves time and energy. Arranging
items nearby is convenient, saves time,
and avoids unnecessary stretching and
twisting of muscles on the part of the
nurse.
3. Perform hand hygiene and put on PPE, if
indicated.
Hand hygiene and PPE prevent the spread
of microorganisms. PPE is required based
on transmission precautions

7. ACTION RATIONALE
4. Identify the patient. Identifying the patient ensures the right
patient receives the intervention and helps
prevent errors
5. Close the curtains around the bed and
close the door to the room, if possible.
Discuss procedure with patient and assess
the patient’s ability to assist with the
procedure, as well as personal hygiene
preferences
This ensures the patient’s privacy. This
discussion promotes reassurance and
provides knowledge about the procedure.
Dialogue encourages patient participation
and allows for individualized nursing care
6. Put on gloves Gloves prevent exposure to blood and
body fluids
7. Assist the patient to an appropriate
position, as necessary: standing at the
bedside, lying on one side or back, sitting
in bed with the head elevated, or sitting on
the side of the bed.
These positions facilitate voiding and
emptying of the bladder

8. ACTION RATIONALE
8. If the patient remains in the bed, fold the
linens just enough to allow for proper
placement of the urinal
Folding back the linen in this manner
minimizes unnecessary exposure while still
allowing the nurse to place the urinal.
9. . If the patient is not standing, have him
spread his legs slightly. Hold the urinal
close to the penis and position the penis
completely within the urinal. Keep the
bottom of the urinal lower than the penis. If
necessary, assist the patient to hold the
urinal in place.
Slight spreading of the legs allows for
proper positioning of the urinal. Placing
penis completely within the urinal and
keeping the bottom lower than the penis
avoids urine spills
10. Cover the patient with the bed linens Covering promotes warmth and privacy.
11. Place call bell and toilet tissue within easy reach.
Have a receptacle, such as plastic trash bag, handy
for discarding tissue. Ensure the bed is in the lowest
position. Leave patient if it is safe to do so. Use side
rails appropriately
Falls can be prevented if the patient does not have to
reach for items he needs. Placing the bed in the
lowest position promotes patient safety. Leaving the
patient alone, if possible, promotes self-esteem and
shows respect for privacy. Side rails assist the
patient in repositioning.

9. ACTION RATIONALE
12. Remove gloves and additional PPE, if
used. Perform hand hygiene
Proper removal of PPE reduces
transmission of microorganisms. Hand
hygiene deters the spread of
microorganisms.
Removing the Urinal
13. Perform hand hygiene. Put on gloves
and additional PPE, as indicate
Hand hygiene and PPE prevent the spread
of microorganisms. Gloves prevent
exposure to blood and body fluids. PPE is
required based on transmission
precautions
14. Pull back the patient’s bed linens just
enough to remove the urinal. Remove the
urinal. Cover the open end of the urinal.
Place on the bedside chair. If patient needs
assistance with hygiene, wrap tissue
around the hand several times, and wipe
Covering the end of the urinal helps to
prevent the spread of microorganisms.

10. ACTION RATIONALE
15. Return the patient to a comfortable
position. Make sure the linens under the
patient are dry. Remove your gloves and
ensure that the patient is covered.
Proper positioning promotes patient
comfort. Removing contaminated gloves
prevents spread of microorganisms.
16. Ensure patient call bell is in reach. Promotes patient safety
17. Offer patient supplies to wash and dry
his hands, assisting as necessary.
Washing hands after using the urinal helps
prevent the spread of microorganisms
18. Put on clean gloves. Empty and clean
the urinal, measuring urine in graduated
container, as necessary. Discard trash
receptacle with used toilet paper per
facility policy.
Measurement of urine volume is required
for accurate intake and output records

11. ACTION RATIONALE
19. Remove gloves and additional PPE, if
used, and perform hand hygiene.
Gloves prevent exposure to blood and body
fluids. Removing PPE properly reduces the
risk for infection transmission and
contamination of other items. Hand hygiene
prevents the spread of microorganisms.