UCR-Gen
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Infection Prevention Quality Improvement Tools
Clinical Practice Rapid Improvement Tool : Urinary Catheter Insertion
Functional Area:
Start Date:
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Overall Auditors:
Module: Urinary Catheter Insertion
Date:
Auditors:
Standard: Evidence based best practice is being consistently applied to prevent catheter associated urinary tract infections
Question Set: Urinary Catheter Insertion - Urinary Catheter Insertion
Question
Guidance
1
Have alternatives to urinary catheterisation
been considered and documented?
Review documentation.
2
Is hand hygiene performed before urinary
catheterisation?
Observe practice. Moment 2 - before an aseptic task.
3
Are single use sterile gloves worn for the
aseptic procedure?
Observe practice.
4
Is a single use apron worn for urinary
catheterisation?
Observe practice.
5
Is the urethral meatus area cleaned with
sterile normal saline prior to urinary
catheterisation?
Observe practice.
6
Is the catheter connected aseptically to a
sterile closed drainage system?
Observe practice.
Observation: 1
Yes
No
N/A Comment
Question Set Comments/Recommendations for Urinary Catheter Insertion - Urinary Catheter Insertion
Question Set: Urinary Catheter Insertion - Urinary Catheter Insertion
Question
Guidance
1
Have alternatives to urinary catheterisation
been considered and documented?
Review documentation.
2
Is hand hygiene performed before urinary
catheterisation?
Observe practice. Moment 2 - before an aseptic task.
3
Are single use sterile gloves worn for the
aseptic procedure?
Observe practice.
4
Is a single use apron worn for urinary
catheterisation?
Observe practice.
5
Is the urethral meatus area cleaned with
sterile normal saline prior to urinary
catheterisation?
Observe practice.
6
Is the catheter connected aseptically to a
sterile closed drainage system?
Observe practice.
Observation: 2
Yes
No
N/A Comment
Page 1 of 3
UCR-Gen
Page 2 of 3
Infection Prevention Quality Improvement Tools
Clinical Practice Rapid Improvement Tool : Urinary Catheter Insertion
Page 1
2 of 3
Question Set Comments/Recommendations for Urinary Catheter Insertion - Urinary Catheter Insertion
Question Set: Urinary Catheter Insertion - Urinary Catheter Insertion
Question
Guidance
1
Have alternatives to urinary catheterisation
been considered and documented?
Review documentation.
2
Is hand hygiene performed before urinary
catheterisation?
Observe practice. Moment 2 - before an aseptic task.
3
Are single use sterile gloves worn for the
aseptic procedure?
Observe practice.
4
Is a single use apron worn for urinary
catheterisation?
Observe practice.
5
Is the urethral meatus area cleaned with
sterile normal saline prior to urinary
catheterisation?
Observe practice.
6
Is the catheter connected aseptically to a
sterile closed drainage system?
Observe practice.
Observation: 3
Yes
No
N/A Comment
Question Set Comments/Recommendations for Urinary Catheter Insertion - Urinary Catheter Insertion
Question Set: Urinary Catheter Insertion - Urinary Catheter Insertion
Question
Guidance
1
Have alternatives to urinary catheterisation
been considered and documented?
Review documentation.
2
Is hand hygiene performed before urinary
catheterisation?
Observe practice. Moment 2 - before an aseptic task.
3
Are single use sterile gloves worn for the
aseptic procedure?
Observe practice.
4
Is a single use apron worn for urinary
catheterisation?
Observe practice.
5
Is the urethral meatus area cleaned with
sterile normal saline prior to urinary
catheterisation?
Observe practice.
6
Is the catheter connected aseptically to a
sterile closed drainage system?
Observe practice.
Observation: 4
Yes
No
N/A Comment
Page 2 of 3
UCR-Gen
Page 3 of 3
Infection Prevention Quality Improvement Tools
Clinical Practice Rapid Improvement Tool : Urinary Catheter Insertion
Page 1
3 of 3
Question Set Comments/Recommendations for Urinary Catheter Insertion - Urinary Catheter Insertion
Question Set: Urinary Catheter Insertion - Urinary Catheter Insertion
Question
Guidance
1
Have alternatives to urinary catheterisation
been considered and documented?
Review documentation.
2
Is hand hygiene performed before urinary
catheterisation?
Observe practice. Moment 2 - before an aseptic task.
3
Are single use sterile gloves worn for the
aseptic procedure?
Observe practice.
4
Is a single use apron worn for urinary
catheterisation?
Observe practice.
5
Is the urethral meatus area cleaned with
sterile normal saline prior to urinary
catheterisation?
Observe practice.
6
Is the catheter connected aseptically to a
sterile closed drainage system?
Observe practice.
Observation: 5
Yes
No
N/A Comment
Question Set Comments/Recommendations for Urinary Catheter Insertion - Urinary Catheter Insertion
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