Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [178], C).
2. 2.Show
   Screen the bed.
   To ensure the patient's privacy (NMC [178], C). To allow dust and airborne organisms to settle before the field is exposed (Fraise and Bradley [81], E).
3. 3.Show
   Take the trolley to the patient's bedside, disturbing the screens as little as possible.
   To minimize airborne contamination (Fraise and Bradley [81], E).
4. 4.Show
   Wash hands using bactericidal soap and water or alcohol‐based handrub.
   To reduce the risk of infection (NHS England and NHSI [161], C).
5. 5.Show
   Put on personal protective equipment.
   To reduce the risk of cross‐infection (NHS England and NHSI [161], C).
6. 6.Show
   Assist the patient into a comfortable position. The patient can lie on the bed in the supine position or sit on the edge of the bed.
   To ensure the appropriate area is easily accessible. E

Procedure

1. 7.Show
   Assist the patient to remove his underwear. Use a sheet or disposable towels to cover his thighs.
   To maintain privacy and dignity (NMC [178], C).
2. 8.Show
   Position a disposable pad under the patient's buttocks and thighs.
   To ensure urine does not leak onto the bedclothes. E
3. 9.Show
   Clean hands with an alcohol‐based handrub.
   Hands may have become contaminated by handling the patient, bedding and pads (NHS England and NHSI [161], C).
4. 10.Show
   Put on non‐sterile gloves.
   To reduce the risk of cross‐infection (NHS England and NHSI [161], C).
5. 11.Show
   With one hand, retract the foreskin (if necessary) and with the other hand clean the penis with soap and water. Dry completely and reduce or reposition the foreskin.
   To remove old adhesive and ensure the sheath sticks to the skin. E

   To prevent retraction and constriction of the foreskin behind the glans penis (paraphimosis), which may occur if this is not performed (Nazarko, [159], E).
6. 12.Show
   Using scissors, trim any excess pubic hair from around the base of the penis.
   To prevent the sheath from painfully pulling pubic hair when applied. (Woodward [258], E).
7. 13.Show
   Apply the sheath following the manufacturer's guidelines, ensuring that there is a space between the glans penis and the sheath. Squeeze the sheath gently around the penile shaft.
   To prevent the sheath from rubbing the glans penis and causing discomfort and potential skin irritation, and to ensure the sheath has adhered to the penis (Nazarko, [159], E).
8. 14.Show
   Connect the catheter bag and ensure the tubing is not kinked.
   To facilitate drainage of the urine into the catheter bag. E
9. 15.Show
   Remove gloves and apron. Dispose of all waste and equipment in a clinical waste bag and seal the bag as per local policy.
   For infection control (NHS England and NHSI [161], C).

Post‐procedure

1. 16.Show
   Provide any assistance the patient may need to dress, encouraging loose clothing where possible. Draw back the curtains once the patient is dressed.
   To maintain the patient's dignity (NMC [178], C) and to avoid any unnecessary kinking of the sheath or its tubing. E
2. 17.Show
   Record information in the relevant documents; this should include:

   • reasons for applying penile sheath
   • date and time of application
   • sheath type
   • sheath length and size
   • sheath manufacturer
   • any problems negotiated during the procedure
   • a review date to assess the need for reapplication.
   To provide a point of reference or comparison in the event of later queries (NMC [178], C).