Postoperative Voiding Rules May Need Review

Many more surgeries now performed on outpatient basis
By Jane Parry
HealthDay Reporter

THURSDAY, May 28 (HealthDay News) -- The requirement of postoperative voiding before discharge may unnecessarily delay patients from leaving the hospital, particularly with the growing number of surgical procedures that are now performed on an outpatient basis, according to an article published in the May issue of the AORN Journal.

Maureen Ruhl, R.N., of the Hospital of the University of Pennsylvania in Philadelphia, assessed current standards, presented a case study, and conducted a literature review to formulate recommendations for future research on voiding criteria. She found that voiding is a typical criterion for patients who have a history of postoperative urinary retention, received a large amount of narcotics, received a spinal or epidural anesthesia, or who underwent urological, anorectal or gynecological surgery.

Requiring all patients who meet these criteria to stay in the hospital until they have voided may cause unnecessary anxiety and create backups in the operating room, the author notes. The literature review revealed that discharge is delayed for between 5 and 19 percent of outpatients because they cannot urinate postoperatively.

"Can some low-risk patients be excused from this discharge requirement? There is guidance in the literature that suggests it is feasible for some low-risk patients," the author concludes. "Goals of ambulatory surgery include providing patients with the safest and most effective care while minimizing complications and patient and family member anxiety. By investigating ways to improve service to patients, clinicians will continue to provide the highest quality care while reducing costs without compromising patient satisfaction."

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