Rethinking Urinary Catheterization in Surgery Care: Practice Patterns and Challenges of Intraoperative Catheter-free Management in Chinese Hospitals.

PURPOSE: To investigate the current status, practice patterns, and barriers of intraoperative catheter-free management (ICFM) among operating room nurses in China, within the framework of Enhanced Recovery After Surgery.

DESIGN

A nationwide cross-sectional survey using stratified cluster random sampling.

METHODS

Data were analyzed using descriptive statistics, χ2 tests, logistic regression, and Pearson correlation.

FINDINGS: A total of 212 valid responses were collected from operating room nurses across 120 hospitals. Among the respondents, 83.5% expressed willingness to implement ICFM under appropriate conditions, and 46.7% reported being familiar with the concept. ICFM was most commonly applied in surgeries under local infiltration (89.6%) or nerve block anesthesia (70.3%), and with durations less than 2 hours (65.1%). Adoption rates were highest in ophthalmology (79.7%) and otolaryngology (80.7%), but lowest in gynecology (13.2%) and urology (14.6%). Major barriers included lack of institutional protocols (59.4%), limited staff acceptance (61.3%), and technical challenges (47.6%). Logistic regression found no significant demographic predictors of ICFM support.

CONCLUSIONS

ICFM is supported by a majority of nurses but remains selectively applied in low-risk procedures. Broader implementation requires standardized guidelines, improved staff training, and technological support for non-invasive bladder monitoring.