Midnight Removal: an Improved Approach to Removal of Catheters

Abstract

There is no recognised policy regarding the timing of urethral catheter removal, although early morning removal is commonly practised. Removing the catheter at midnight allows patients to return to a normal voiding pattern more rapidly and to leave hospital earlier.

Removal of Catheter at Midnight versus Early Morning: The Patients’ Perspective

“…A busier early-morning shift may consequently lead to delays in the actual ROC, and it has been suggested that the midnight ROC may be more amenable [2] . We are able to confi rm that there was no recatheterization at an unsociable hour when the catheter was removed late at night [2,5] ; however, this was necessary with 2 patients who had a ROC performed at 06.00 h.…”

“…Several factors must be taken into account in deciding the time of ROC: patients' perspective, the resumption of the normal voiding patterns, and the likelihood of success of the ROC. Some authors [3] have shown no signifi cant difference between ROC at midnight and ROC at 06.00 h with regard to time to fi rst void and initial void volume, while others [2] have shown a longer time to fi rst void and a larger initial void volume with midnight ROC. An earlier discharge from hospital was noted with midnight ROC [1][2][3] .…”

“…Some authors [3] have shown no signifi cant difference between ROC at midnight and ROC at 06.00 h with regard to time to fi rst void and initial void volume, while others [2] have shown a longer time to fi rst void and a larger initial void volume with midnight ROC. An earlier discharge from hospital was noted with midnight ROC [1][2][3] . This may not be the case with an effi cient discharge planning and by a nurse-led discharge service that is guided by discharge guidelines.…”

“…The resumption of a normal voiding pattern is crucial to the discharge of the patient, and, therefore, an early resumption of the voiding pattern would be beneficial to the patients and also may have a signifi cant economic benefi t to the hospital [2] . Tradition seems to favour removal of catheters (ROC) at 06.00 h, while some centres favour ROC at midnight.…”

“…Tradition seems to favour removal of catheters (ROC) at 06.00 h, while some centres favour ROC at midnight. ROC at midnight has been shown to result in an earlier discharge with improved voiding volumes [2] . Several factors must be taken into account in deciding the time of ROC: patients' perspective, the resumption of the normal voiding patterns, and the likelihood of success of the ROC.…”