Catheterization of urinary bladder with help of a soft catheter

№

Skills/ Assessment criteria

Step by step assessment in points

1

Keeping sanitary-epidemic regime at a procedure room

4,0

Dress a oilcloth apron above medical uniform, put on gloves.

0,2

Prepare capacity with disinfectant & special clean rag.

0,2

Process surfaces keep in order: cabinet, medical table, nurse table, chair, fridge, couch, roll, windowsill, radiator, water tap, sink, door handle, and floor.

0,6

After cleaning switch on a bactericidal lamp for 60 minutes.

0,5

Shut the door of the procedure room tightly, anyone mustn't enter there.

0,5

Switch off a bactericidal lamp, ventilate the room.

0,4

Used tools must be undergone disinfection.

0,2

Write down the mark to register of disinfection of a procedure room.

0,4

Comply a schedule of general cleaning of a procedure room, ratified by the Head nurse of a department (once per a week).

0,2

Previously, it is necessary to wash a room using cleanser.

0,2

Process the room using disinfectant.

0,4

Scrupulously wash walls, door, move furniture, corners, baseboards, floor on a perimeter, & then in a center.

0,2

2

Taking blood sample from a vein

4,0

Explain a patient the purpose & progress of an investigation & take his (her) agreement. If it’s necessary give instructions & compose the algorithm for preparing of a patient to procedure. Prepare equipment, mark the test-tube & direction. Help a patient take comfortable position (horizontal or semi-sitting) for a vein puncture.

0,5

Wash & dry hands, dress uniform, gloves.

0,3

Put oilcloth pillow under the elbow of a patient. Fix tourniquet on a middle third of a shoulder. Its loop must be directed downward, & free ends upward (napkin or shirt sleeve should be put between tourniquet & shoulder skin).

0,5

Ask the patient flex & relax his (her) fist. Find the fullest vein. Process skin of cubital fossa twice with cotton ball or napkin, moistened with 70% alcohol, changing it & keeping aseptic rules.

0,5

Perform a venipuncture. Sure the needle is in a vein: pull a piston. Continuing to pull the piston, take necessary volume of blood.

0,5

Take off a tourniquet before eject a needle from a vein. Press the place of a puncture with sterile cotton ball (napkin), moistened with 70% alcohol, during ejecting the needle. Fix the ball for 1-2 minutes, then throw it to capacity with disinfectant.

0,5

Stream slowly blood to the test-tube, which placed in a holder. Put the syringe to the capacity with disinfectant.

0,3

Help a patient stand up or lie down comfortably.

0,2

Set a holder to container, then to a bix, compacted using cotton or foam rubber.

0,2

3

Carrying out of intravenous injection

4,0

Prepare necessary equipment. Establish friendly relationship with a patient. Explain a patient purpose & progress of the procedure; take his (her) agreement.

0,3

Put on a mask, process hands using hygienic way, put on gloves.

0,5

Open the package, collect a syringe, and process a neck of an ampule twice with cotton ball, moistened alcohol.

0,5

Extract the medicine (dose, prescribed by a doctor) from an ampule. Take off the needle; throw it to capacity with disinfectant. Put a sterile needle on the syringe, output air, close the needle with top. Put the syringe on a tray.

0,5

Help a patient to sit or lie down on a couch. Cover the patient shoulder with napkin & put a rubber tourniquet there. Oilcloth pillow must be placed under the elbow. Examine the vein. Process skin of cubital fossa twice with cotton ball moistened with alcohol (throw the used balls to capacity filled 3% chloramine solution).

0,5

Take the syringe & take off the top. Check absent of air into the syringe. Hold the syringe so, that hole of the needle will be located upwards. Fix the needle cannula by 2nd finger. Fix the vein by 1st finger of the left hand, pierce skin, and enter a third part of the needle to the vein, in parallel. Pull a piston. When blood will be seen into the syringe, the tourniquet must be taken off.

0,3

Inject a medicine slowly, pushing a piston of the syringe. When the medicine has being injected, the needle must be ejected from a vein. In that moment, hold a body of the syringe & fix a cannula of the needle. Ask the patient flex his (her) arm in elbow, press a cotton ball, moistened with alcohol, to the place of injection.

0,3

Throw the used equipment (the syringe with the needle, its top) to a special container for used materials.

0,3

Inspect the place of injection. If there’s no bleeding, take away the cotton ball, moistened with alcohol, & throw it to a special capacity for things contacted with blood.

0,3

4

Collect equipment (dropper) for intravenous dropping infusion of medicines, its carrying out

4,0

Establish friendly relationship with a patient. Explain a patient purpose & progress of the procedure; take his (her) agreement.

0,5

Process the hands using hygienic way, dress a sterile uniform, mask, gloves. Prepare the one-off dropper. Prepare a sterile tray containing with napkins, cotton balls & forceps. Prepare the vial with medicine for infusion.

0,4

Remove the metallic cover by scissors. Process the vial stopple with alcohol twice. Close the clip of the dropper. Turn a vial upside down, hang it on a holder.

0,5

Keep attention that the dropper & vial will be on the same level. Fill the dropper close to a half. Down the end of tube & fill the dropper completely, close the clip. Put on the needle with top.

0,5

Patient takes comfortable position. Put oilcloth pillow under the patient elbow, examine a vein. Cover a middle part of a patient shoulder with napkin & tie a rubber tourniquet. Palpate the vein. Process the place of venipuncture twice by cotton ball, moistened with 70% alcohol.

0,5

Take off a top from the needle. Ask the patient squeeze a fist.

0,3

Inject third part of the needle into the vein; put a sterile napkin under the cannula. Take off the tourniquet. Open the dropper clip. Regulate speed of medicine stream by the clip. Fix the needle with plaster & cover the place of infusion with a sterile napkin. Observe the patient condition for all period of infusion.

0,5

Eject the needle from the vein when infusion has being finished; press a cotton ball, moistened with antiseptic to the place of puncture. Ask the patient flex his (her) arm in elbow (cotton ball can be fixed with bandage).

0,2

Keeping rules of precaution, put the opened needle to a tray, and then put it to a container for used material at procedure room.

0,2

Inspect the place of venipuncture. If there’s no bleeding, take off the ball, moistened with antiseptic, into a tray. If it’s necessary, put a bandage to the place of infusion.

0,2

Control the patient condition for 40 minutes after the procedure, and then transfer the patient to a ward nurse for observation.

0,2

5

Catheterization of urinary bladder of a woman

4,0

Process hands before catheterization, like before any manipulation including surgical.

0,5

Patient lies on a back, his legs a little flexed in knees. Put a capacity for urine collection between his feet. Wash external sexual organs of a woman using disinfectant (for example, furacilin solution 1:1000), squirt, if she has vaginal discharge.

1,0

Stand on the right of the patient, open labia by left hand, scrupulously wash external sexual organs (from pubis to anus) using disinfectant by right hand.

0,5

Take a catheter by the right hand. Internal end of the catheter must be moistened in sterile oil, & entered to external hole of urethra carefully.

1,0

When urination will stop, presses a little abdominal wall in projection of urinary bladder to help excrete remain urine.

0,5

Explain a patient own acts during the procedure, using patience & kindness, allow her ask questions.

0,5

6

Catheterization of urinary bladder of a man (using a soft catheter)

4,0

Process hands before catheterization, like before any manipulation including surgical.

0,5

Patient lies on a back, his legs a little flexed in knees. Put a capacity for urine collection between his feet.

0,5

Take the penis by left hand & wash its head by cotton, moistened with disinfectant.

0,5

Take the catheter with help of forceps, placing it next to internal end of the catheter. External end of the catheter fix between 5^th & 4^th fingers of the same hand.

0,5

Internal end of the catheter must be moistened in sterile oil, & entered to external hole of urethra carefully.

0,5

Gradually, without sharp force, move the catheter through urethra. Penis is directed to forward.

0,5

Eject the catheter a little earlier before urination stopped that urine stream washes urethra after catheter.

0,5

Explain a patient own acts during the procedure, using patience & kindness, allow him ask questions.

0,5