Urinary Catheter Removal is another procedure you can get as skill demonstration for your NMC OSCE Exam. Time duration for the procedure is now 8 minutes. Main errors candidates make is not emptying the catheter bladder fully while removing catheter. According to authorities, you don’t need to do catheter removal using a dressing set. It is told that this choice is a nurses decision. If you verbalize that catheter site is clean and there is no need to clean it again, you won’t be required to use the dressing set for catheter removal.

Urinary Catheter Removal Procedure for NMC OSCE Skill Demonstration

Lets see the steps involved in catheter removal under the following headings,

Introductory Phase

• Entering the patient room, checking for scene safety, ensuring that scene is safe to approach
• Protecting the privacy and dignity of patient by closing the curtains and doors
• Doing the hand rub using seven steps of hand hygiene
• Hello, myself ‘name of candidate’ and am your attending nurse today
• Can you tell me your name please?
• What can i call you?
• Can you tell me your date of birth?
• Can i confirm the same with your id tag (Name, date of birth, hospital number)
• How are you today?
• Are you comfortable?
• I understand that you are having a urinary catheter in place and i have come to remove that?
• Are you happy for me doing that? Do we need a chaperone? (If patient is of opposite sex, you need to ask for need of chaperone)
• Do you have any allergies? Are you in any pain?
• Do you need to use the toilet now?
• This procedure will take 8 minutes, are you okay for that time?
• Verbalize that this is a painless procedure eventhough you will feel a slight discomfort (for males when catheter passes through prostatic urethra) stinging sensation and discomfort (for females) while removing the catheter
• Is it okay and can i proceed now?
• I am making sure that catheter is emptied and bag is placed on the bedside (without touching), if not empty you will have to wear a gloves and apron for emptying (usually not required). After emptying you need to verbalize that you are going to discard urine in the slooz room.
• Okay now am going to assemble things needed for the procedure, mean while if you need any thing, just press the call bell or you can call me and i will be happy to help you.

Assembling Articles & Hand Washing Phase

• I am wearing an apron and gloves to clean the trolley
• I am confirming with the examiner that whether this trolley is cleaned with soap and water in past 24 hours
• I am going to clean this trolley from further to nearer end and from top to bottom using clinell wipes in a zig zag manner for 30 seconds (after checking expiry of clinell wipes)
• I am going to leave this trolley to leave it dry for another 30 seconds while i will do my hand washing
• Removing the gloves and apron, doing hand washing at wash basin using seven steps of hand hygiene
• Drying hands with paper towels from fingers to wrist
• Now am going to assemble things required for my procedure, assembling dressing set (intact, dry, within expiry), saline sachet (no precipitate, within expiry), incopad, kidney tray, clean glove pack, alcohol hand rub(wiped with clinell wipes and within expiry), alcohol wipe (1), a 10 ml syringe and a pack of sterile gauze
• Am wearing an apron and reading aloud amount of water to be removed from bladder of catheter (as given in scenario)
• Moving to the patient side by only touching the bottom part of the trolley (as in ANTT)

Procedure (at Patient Side)

• Hello ‘Name of patient’ am back with required articles for the procedure
• Are you comfortable now? Can we start the procedure?
• Am wearing a clean gloves, exposing the site and inspecting it
• Verbalizing that the catheter site is clean and there is no need to clean it
• Am putting the incontinent pad beneath the buttocks and a kidney tray between the legs
• Using alcohol wipes am wiping the port for 30 seconds and allowing it to dry for another 30 seconds
• Using the 10 ml syringe am withdrawing (comes itself) 10 ml (usually) as documented from the catheter bladder
• You should tell the patient that to take a deep breath and exhale slowly meanwhile am removing the catheter
• Verbalizing that there is no encrustation or kinking at the catheter tip and the bladder of catheter is empty
• Discarding the catheter along with the gloves in the clinical waste
• I am doing a hand rub putting on a clean gloves, removing the incontinent pad and kidney tray to clinical waste along with the gloves

Health Education Phase

• Verbalizing to patient that the procedure is over (Health educate that you do need to report any increase in frequency, urgency or burning sensation when urinating, Encourage patient to drink 2 – 3 liters of water to flush out the bacteria and prevent Urinary Tract Infection)
• Tell the patient to measure next voiding urine in a pot so that you can measure his/her urinary output
• Give the call bell to call for any assistance if needed
• Wear a new gloves, discard all used items to clinical waste and also verbalize that you will clean the trolley and make it ready for next use
• Do a hand rub and document that urinary catheter removed, 10 ml of urine is removed from catheter bladder as documented before, there were no encrustation or kink in the tip of catheter with date time and signature (Usually documentation will be done in the given scenario)
• Do a proper hand wash or hand rub and leave the room

Conclusion

Don’t forget important points like patient identification, privacy, chaperone, adequate emptying of catheter bladder etc while demonstrating urinary catheter removal skill for NMC OSCE.

We are providing a flow chart video of the urinary catheter removal procedure, so that nurses appearing for NMC OSCE can remember the procedure easily which you can watch here. Please note that the time limit has changed from 15 minutes to 8 minutes now.