Goal: The patient's urinary elimination is maintained, with a urine output of at least 30 mL/hour, and the bladder is not distended.
1. Bring necessary equipment to the bedside.
2. Perform hand hygiene and put on PPE, if indicated.
3. Identify the patient.
4. Close curtains around bed and close the door to the room, if possible. Discuss the procedure with patient. Ask the patient if he has any allergies, especially to latex.
5. Adjust bed to comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Stand on the patient’s right side if you are righthanded, or on patient’s left side if you are left-handed.
6. Prepare urinary drainage setup or reusable leg bag for attachment to condom sheath.
7. Position patient on his back with thighs slightly apart. Drape patient so that only the area around the penis is exposed. Slide waterproof pad under patient.
8. Put on disposable gloves. Trim any long pubic hair that is in contact with penis.
9. Clean the genital area with washcloth, skin cleanser, and warm water. If patient is uncircumcised, retract foreskin and clean glans of penis. Replace foreskin. Clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward. Wash the shaft of the penis using downward strokes toward the pubic area. Rinse and dry. Remove gloves. Perform hand hygiene again.
10. Apply skin protectant to penis and allow to dry.
11. Roll condom sheath outward onto itself. Grasp penis firmly with nondominant hand. Apply condom sheath by rolling it onto penis with dominant hand. Leave 1 to
2 inches (2.5 to 5 cm) of space between tip of penis and end of condom sheath.
12. Apply pressure to sheath at the base of penis for 10 to 15 seconds.
13. Connect condom sheath to drainage setup. Avoid kinking or twisting drainage tubing.
14. Remove gloves. Secure drainage tubing to the patient’s inner thigh with Velcro leg strap or tape. Leave some slack in tubing for leg movement.
15. Assist the patient to a comfortable position. Cover the patient with bed linens. Place the bed in the lowest position.
16. Secure drainage bag below the level of the bladder. Check that drainage tubing is not kinked and that movement of side rails does not interfere with the drainage bag.
17. Remove equipment. Remove gloves and additional PPE, if used. Perform hand hygiene.
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