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What is the best time of day to remove a urinary catheter?

  • Comments (16)

What is the best time of day to remove a urinary catheter? What do you think?

Traditionally patients would have a trail removal of urinary catheters at 6am. This allows time during the day for the patient to pass urine or to receive appropriate treatment if they go on to develop urinary retention.

Some urology wards remove urinary catheters at midnight. This allows the bladder to fill while the patient is asleep so they pass urine when they wake up. If they have problems with urinary retention these can be identified and managed earlier in the day.

One suggested advantage of the trail removal at midnight is earlier discharge from hospital and improved bed management. However, there appears to be very little evidence to support either approach or the outcome for patients.

  • Comments (16)

Readers' comments (16)

  • Anonymous

    It does make me cringe to hear that the benefit of removing catheters at midnight improves bed management, instead of highlighting the benefit to patient's wellbeing/quality of care, etc. We are de-humanising the NHS with all this jargon, which is rife in the NHS, and we adopt it so willingly!!

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  • Anonymous

    can be removed at any time to suit the patient, preferably in the morning to give them patient time to readjust and to re-catheterise later in the day if necessary.

    should it read 'trial' above? trail may be interpreted otherwise!

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  • Anonymous

    I wouldn't have thought midnight would be a good option, due to staffing numbers, therefore less monitoring of output. 6 am: Inhumane to the poor patient (unless of course, they wake at that time and are happy for it to be done then).

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  • Anonymous

    I see no reason for disturbing a patient's sleep for the removal of a urinary catheter. Is this for the convenience of the ward?

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  • Hi Eileen,
    I am aware that the practice of twoc's varies from place to place, but we encourage our intermediate care team to remove the cathteter before 12 midnight.This has been succesful in that patients go to sleep and wake up, then void sucessfully.

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  • I've worked in areas where planned TWOCs were at MN or 6am, & where they're taken out as soon as decision made on ward round.
    I think the comment in the article about bed management is unfortunate as it deflects from the more patient-centred focus of the previous paragraph. MN catheter removals might on the the surface appear more for the benefit of routine (as per anon 28/3 12.01pm) & to disturb sleep. Every patient is different, but generally my experience was that patients TWOC'd at MN (or in reality, post night-time drug round/before they settled) would eventually sleep, so not be worrying about whether they'd passed water yet or comparing themselves to Joe Bloggs in bed next door who had done. By the morning, they had a reasonable volume of urine in their bladder, helping their bladder muscles readjust to being 'full' & having less problems with frequency. If they did have problems with retention, these happened in daytime when more staff around to address. Yes, if it was a successful TWOC, it would be known early enough in the day for discharge, but that wasn't the main reason for the timing.
    I guess the real question is the lack of evidence & doing the research to check out these perceptions.

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  • Anonymous

    In my experience ladies tend to get TWOCed at night and gents in the morning.This is because if ladies have problems the nurses can deal with it. If gents have problems especially if they have had surgery, the doctor or consultant may be needed to do the catheterisation.

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  • Abot 10 minutes after my shift has finished.

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  • Anonymous

    the best time is that which best suits the patient. they should know best if you ask them if they are conscious and able to communicate. but preferably not while they are sleeping or need to be woken up, just before meals, before visiting time, before any investigations or just before they may be going off the ward for any other reason.

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  • Anonymous

    they sometimes come out of their own accord!

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