From the Guidelines
Urinary catheters can be removed in the evening in Enhanced Recovery After Surgery (ERAS) protocols, as early removal is advocated to encourage mobility, improve patient comfort, and reduce the incidence of catheter-associated urinary tract infection (CAUTI) 1. When considering the removal of urinary catheters in the evening, it is essential to weigh the benefits of early removal against the need for strict monitoring of urine output and fluid balance in certain patients, such as those with sepsis or acute physiological derangement 1.
Key Considerations
- Early removal of urinary catheters is associated with reduced incidence of CAUTI, which increases with duration of catheterization 1
- Presence of a urinary catheter is associated with a significantly increased risk of delirium in older adults 1
- Evening removal may benefit patients by allowing for a full night's sleep without disruption and potentially earlier discharge if voiding is successful
- Nursing staff should ensure adequate monitoring for post-removal urinary retention, with protocols in place for bladder scanning and potential re-catheterization if needed
Patient-Specific Factors
- Age, gender, surgery type, and medication use should be considered when deciding on the timing of catheter removal
- Patients with pelvic surgery, immobility, sedation, or epidural analgesia may require continued catheterization 1
- Patients should void within 6-8 hours after catheter removal, and adequate fluid intake should be maintained The decision to remove urinary catheters in the evening should be based on individual patient risk factors, staffing patterns, and monitoring capabilities during night hours, with the goal of removing catheters as early as safely possible to reduce infection risk and promote mobility 1.
From the Research
Removal of Urinary Catheters in ERAS Protocols
- The removal of urinary catheters is a component of Enhanced Recovery After Surgery (ERAS) protocols, which aim to minimize the body's response to surgical stress and promote rapid recovery 2, 3.
- ERAS protocols involve the implementation of evidence-based elements of care, including the avoidance of or early removal of drains and tubes, such as urinary catheters 2, 3.
- The goal of ERAS programs is to promote rapid recovery, decrease the length of hospital stay, and reduce complications and cost 4, 3.
- While the specific timing of urinary catheter removal is not mentioned in the provided studies, the general principle of early removal of tubes and drains is a key component of ERAS protocols 2, 3.
- It is possible that urinary catheters could be removed in the evening as part of an ERAS protocol, but this would depend on the individual patient's needs and the specific protocol being followed 2, 3.