Does evening removal of urinary catheters shorten hospital stay among general hospital patients? A randomized controlled trial

Abstract

Objective: Literature indicates that removing urinary catheters at midnight facilitates earlier discharge among urology patients, but the effect of evening removal on the general patient population is unknown. The objective of this study was to investigate whether removing a urinary catheter at 22.00 hours compared to 06.00 hours among a general hospital population would lead to earlier hospital discharge.

Design: Randomized controlled trial.

Setting and subjects: The study was conducted in a large tertiary hospital in Brisbane, Australia. Two hundred and ten general surgical and medical patients who had an indwelling catheter as part of their routine care were included.

Results: Length of hospital stay after catheter removal was not significantly affected by the timing of its removal among general hospital patients: mean hours morning 186.1; mean evening 209.3, (P = .309). In a cohort of surgical patients, the hospital stay was shorter in the evening removal group (mean hours morning 186.1; mean evening 209.3), but this result was not statistically significant (P = .127). Patients in the evening group were more likely to have a longer time period between catheter removal and the first postcatheter void, mean hours morning, 3.76 vs evening, 4.89 (t = -2.59, CI - 1.99 to -0.27). Timing of removal of the urinary catheter had no effect on the volume of the first void, mean volume morning, 214.7 mL vs evening, 221.4 mL. Twenty-five (12.1%) patients were recatheterized, but the rate of recatheterization between groups was similar. There were no differences in postdischarge problems between groups.

Conclusion: Among general hospital patients, removing an indwelling urinary catheter at 22:00 hours does not shorten the length of stay and is effective in increasing the time to first void.