Day Zero Urinary Catheter Removal in Gen Thoracic Surgery Patients

Study Design A prospective study design will be utilized as data will be collected in a prospective manner and standard of care/current practice will be unaltered in the patient population.

Sampling will include all patients that meet the eligibility criteria from March 01, 2011 until August 01, 2011 with a goal of forty-five patients.

Data Collection Protocol

1. The patient will be interviewed and given information regarding participation in the study by Principal Investigator and/or research team prior to surgery. Informed Consent Forms will be collected by Principal Investigator and/or research team. Principal Investigator and/or research team will collect all data on Data Collection Sheet.

2. Thoracic epidural will be placed by the anesthesiologist in pre-op per standard protocol.

   • Location of epidural will be documented by Principal Investigator and/or research team on Data Collection Sheet. (See Appendix 1)
3. Prior to surgery, if indicated, an indwelling urinary bladder catheter will be placed per pre-operative protocol.
4. Post-operative documentation of time, type and settings for epidural infusion will be documented on Data Collection Sheet.

5. Post-op eligible patients admitted to cardiothoracic step-down unit will be placed on the following protocol:

   • Thoracic Epidural will be managed by the anesthesia group.

     • Any change in prescription or dosing will be documented on the Data Collection Sheet.

   • If urinary catheter present, will be discontinued at midnight day of surgery, Day Zero; the time of discontinuation will be noted on the Data Collection Sheet.

     • If micturition occurs, amount and time will be documented on Data Collection Sheet.
     • If no spontaneous void by 0800 post-operative day (POD) 1, bladder scanning will be initiated.
     • If ≥ 400 cc per bladder scanner, the thoracic surgeon, surgeon's nurse or the Principal Investigator will not notified.

   • Any ordered interventions, the response and re- evaluation will be noted on Data Collection Sheet.

     • Urinary retention will be defined as > 400 cc and recatheterization (either intermittent or indwelling) will occur.
6. Data will only be collected during current surgery hospitalization.