Introduces self
0
1

Confirms name & date of birth of patient (against wristband if present)
0
1

Explains & gains consent
0
1

Arranges chaperone, closes curtains/sign/locks door
0
1

Gathers equipment
0
1

Puts apron on and cleans trolley with multiple disinfectant wipes and leaves to dry
0
1

Washes hands
0
1

Asks patient to lie on their back, as flat as possible, with their legs slightly apart and asks patient to retract their foreskin.
0
1

Opens sterile pack without touching the inside and drops it onto trolley
0
1

Unwraps the sterile pack touching only the edges
0
1

Checks expiry date of catheter (Foley 12 to 14), opens pack and drops it into sterile field
0
1

Pours sterile water into small bowl with swabs
0
1

Opens plastic prongs onto sterile field
0
1

Assembles syringe of 10ml sterile water and places it under sterile field
0
1

Wears sterile gloves with sterile technique
0
1

Makes hole in drape and places it on patient such that the penis passes through
0
1

Forms a sling using gauze to hold penis
0
1

Cleans around urinary meatus using plastic prongs to hold swabs, disposing each as it is used
0
1

Warning the patient that it may sting, inserts anaesthetic into urethra and gently occludes meatus for 3 to 5 minutes
0
1

Changes gloves (or removes top gloves if using double glove technique)
0
1

Places end of catheter in cardboard container and places container between the patient's legs
0
1

With one hand, holds sling to angle penis vertically and inserts catheter touching only the plastic covering
0
1

Lowers the penis when resistance is felt and continues to insert catheter
0
1

Inflates balloon very slowly with 10ml sterile water asking the patient if they feel any pain
0
1

Tugs on the catheter to check it is secure
0
1

Attaches the catheter to the catheter bag
0
1

Asks the patient to replace foreskin
0
1

Dispose of all equipment in clinical waste bin
0
1

Documents size of catheter, residual volume (using stickers from catheter pack)
0
1

Washes hands
0
1

Deals with any questions or concerns
0
1

Thanks patient
0
1

Examiner global score: confidence, methodical and proficient
0
1
2