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

Objective: Literature indicates that removing urinary catheters at midnight facilitates earlier discharge amongst urology patients but the effect of evening removal on general patients is unknown. The objective of the present study was to investigate whether removing a urinary catheter at 22.00 hours compared to 06.00 hours amongst a general hospital population would lead to earlier hospital discharge. Design: A 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 following 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 = 0.309). 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 statistical significant (p = 0.127). Patients in the evening group were more likely to have a longer time period between catheter removal and the first post-catheter void, mean hours morning, 3.76 v evening. 4.89 (t = - 2.59, confidence interval –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 mls v evening, 221.4 mls. Twenty five (12.1%) patients were re-catheterized but the rate of recatheterisation between groups was simliar. There were no differences in post discharge problems between groups. Conclusion: Amongst general hospital patients, removing an indwelling urinary catheter at 22:00 hours does not shorten the length of stay but is effective in increasing the time to first void.