Urinary Catheterization Skills: One Simulated Checkoff Is Not Enough

BackgroundSkills in aseptic technique are essential competencies for preventing infection; yet, aseptic technique is a difficult concept to master. During urinary catheter insertion, failure to properly adhere to strict aseptic technique has been linked to infections and sepsis. This pilot study used simulation to identify the most common breaches in aseptic technique during urinary catheter insertion.MethodsBaccalaureate nursing students with prior documentation of competency were recruited to demonstrate performance of urinary catheterization on a task trainer. The procedure was recorded, and breaches in technique were identified through review of the digital recordings.ResultsData were available for 13 participants. Participants ranged in age from 21 to 43 years (mean, 26.6). Ten participants (77%) were female and three (23%) were male. The participants' mean self-rating of confidence was 3.6 on a 5-point scale (range, 3-5), indicating some confidence in performing the skill. Examination of the video recorded data showed that 10 participants (77%) breached aseptic technique in at least one category and in some instances several categories. The most common breach was cleansing the meatus; seven participants (54%) performed it incorrectly.ConclusionsOne-time competency validation using a simulator is not enough to ensure skill mastery or retention. Urinary catheter insertion is a high-risk skill and therefore should be afforded ample time to practice. Innovative approaches to ensure skill mastery, including urinary catheterization and other skills requiring sterile techniques, are needed.