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Trial of voiding assesses a patient's ability to urinate after removal of an indwelling catheter. An investigation to determine how the procedure was performed at 42 sites nationwide was conducted. The findings are summarized.
Trial of voiding (TOV) or voiding trial at the Minneapolis Veterans Affairs (VA) Medical Center is a procedure to assess a patient's ability to void after a Foley catheter is removed. TOV is ordered for most postoperative urology patients prior to discharge from the clinic or hospital. If a new postoperative patient is unable to void following a TOV, the Foley catheter is reinserted and the patient returns to the urology clinic in 1 to 2 weeks to repeat the procedure. Trial of voiding may also be ordered by the physician for patients 1 to 2 weeks following an acute episode of urinary retention.
Our clinic's practice had been to fill the bladder by slowly instilling sterile water or normal saline via the Foley catheter with a 60 cc catheter tip irrigation syringe. Once the patient had the urge to void, the catheter was removed. The amount voided was measured and that volume was subtracted from the amount of water or saline instilled to determine the residual volume. The physician evaluated the volume and determined if the patient passed or failed the TOV. If the TOV was unsuccessful, the Foley catheter was reinserted or the patient was taught how to perform intermittent self-catheterization.
At the Minneapolis VA Medical Center, the Nursing Procedure Manual is used to orient new staff and guide practice for existing staff. While we had performed TOV for years, the procedure for TOV was not included in the procedure manual. A literature search was initiated because nursing procedures at our institution are based on research. The literature search yielded no findings related to TOV or voiding trial.
Purpose
With no literature to serve as a guide, we decided to compare our current practice to practice elsewhere. Hence, the purpose of this investigation was to determine how TOV was being performed in other urology settings and develop a written procedure based on the findings.
Methods
The approaching spring conference for the Upper Midwest Chapter of the Society of Urologic Nurses and Associates (SUNA) provided an excellent opportunity to...