12-hour Shifts Research Articles

A survey of demographic properties of patients who died in intensive care units and their association with the death hour

IntroductionPoor sleep hygiene and the hour of changing shifts are among the most important factors which affect the quality of services in the intensive care unit. The present study aimed to investigate the demographic properties of patients who died in the intensive care unit and their association with their death hour. Materials and methodsAs a cross-sectional study, this study was performed by referring to the Statistics Center of Hazrat Rasool Akram Hospital and collecting the demographic information of dead patients at 12 intensive care units in this hospital. This information includes age, sex, the cause of death, and the exact time of death of these patients. ResultsIn this study, the rate of mortality in intensive care units was assessed as follows; from 12 pm to 2 am (14.48%), from 2 am to 4 (5.49%), from 4 to 6 am (8.99%), from 6 to 8 am (11.32%), from 8 to 10 am (6.79%), from 10 am to 12 noon (8.03%), from 12 to 14 (6.04%), from 14 to 16 (6.93%), from 16 to 18 (7.41%), from 18 to 20 (9.47%), from 20 to 22 (8.1%), and from 22 to 24 hours (6.93%). The highest rate of mortality was between 12–2 AM and then 6–8 AM. In this study, a significant rate of deaths occurred during the night and the lowest rate was during normal work hours and in fact during the morning hours of visiting patients. ConclusionSince the highest rate of mortality was during night hours, during the hours of changing shifts, and at the beginning of midnight, the mortality rate could be decreased with the decrement in staff's working hours and paying more attention to patients during these hours, the overall mortality rate of patients could be decreased in ICU units.

Effect of shift length on paramedic anxiety

Introduction: Paramedics frequently experience extremely stressful situations. A combination of the unknown, long shifts and witnessing human distress and tragedy can have lasting effects on the psyche of these individuals. The purpose of this study was to determine if there was a difference between anxiety levels experienced by paramedics who work 12-hour shifts and those working 24-hour shifts. It was hypothesised that those required to work longer shifts would experience higher levels of anxiety. Methods: This survey research study measured anxiety experienced by paramedic practitioners (n=78) at three local emergency medical services using the Beck Anxiety Inventory. A binary logistical regression analysis was used to determine whether any results met criteria for significance and to determine the odds ratio for categories that did reach significance. Results: Paramedics who worked 24-hour shifts were significantly more likely to experience moderate-to-severe anxiety than those working 12-hour shifts (P=0.042; OR 0.002). Age affects the likelihood that participants experienced moderate-to-severe anxiety (P=0.028; OR=0.594); as age increases, the likelihood of experiencing moderate-to-severe anxiety decreases significantly. Conclusion: Paramedics who worked 24-hour shifts were significantly more likely to experience moderate-to-severe anxiety than those working 12-hour shifts. Age also affects whether paramedics experience moderate-to-severe anxiety; the older the individual, the better able they are at moderating their anxiety. Emergency medical service administrators are encouraged to reconsider the use of 24-hour shifts. If not already in place, strategies should be developed to assist paramedics and other prehospital care practitioners to recognise and address anxiety and other mental health disorders.

Elimination of 24-Hour Call Shifts in an Obstetrics and Gynecology Residency Training Program [ID: 1375098

INTRODUCTION: Resident duty hour restrictions have resulted in improved resident safety with mixed results on patient safety. There are limited data about 24-hour shifts in obstetrics and gynecology. This project studies resident wellness and performance after eliminating 24-hour call shifts. METHODS: This is a preliminary analysis of a quality improvement project. Physicians were surveyed before and after implementation of a call schedule that reduced 24-hour shifts to 14-hour shifts. Resident performance was assessed by self-reported and attending-reported ability to perform tasks. RESULTS: At preintervention survey, 13 out of 16 residents and 8 out of 17 attendings favored eliminating 24-hour call shifts. Attendings had more confidence in residents' performance on 24-hour shifts than residents did (P<.02) when stratified by task and residency year. At 3-month follow-up, all residents (19/19) preferred 14-hour shifts. Residents reported improvements in wellness (13/13), sleep (13/13), and burnout (10/13). Residents felt more confident in their ability to perform a vaginal delivery (11/13), cesarean birth (12/13), or communicate effectively (11/13) with 14-hour compared to 24-hour shifts. Thematic analysis showed that residents felt happier and better able to care for patients. Two residents cited improved ability to learn, while only one resident cited lost learning opportunities. CONCLUSION: Data suggest that obstetrics and gynecology residency programs should eliminate 24-hour shifts to improve resident wellness and performance, while decreasing burnout. Final follow-up data (to be collected March 2023) will assess whether attendings see a change in resident performance.

The State of Rest Break Practices Among 12-Hour Shift Hospital Nurses in the United States.

This cross-sectional study aimed to explore the characteristics, content, and context of rest breaks taken by hospital nurses. Nurses often miss, skip, or take interrupted breaks. To improve the quality of breaks and promote within-shift recovery, it is important to understand current rest break practices including break activities and contextual challenges around them. Survey data from 806 nurses were collected between October and November 2021. Most nurses did not take regular breaks. Rest breaks were often interrupted, spent being worried about work, and rarely resulted in a relaxed state. Common break activities were having a meal or a snack, and browsing the Internet. Regardless of workload, nurses considered patient acuity, staffing, and unfinished nursing tasks when deciding to take breaks. Rest break practices are of poor quality. Nurses mainly consider workload-related factors when taking breaks, which warrants the attention of nursing administration.

Is Nursing Satisfaction Influenced By Having Regular Break Time?

Background: Nursing shortages have been an issue for decades; however, shortages have been on the rise in recent years. The COVID-19 pandemic only exacerbated the issue and brought to light many of the challenges that nurses are facing in the workforce. A common theme has been overworked nurses that are now experiencing burnout, which is causing them to take a break from nursing or leave the field permanently. Objective: The aim of this research study is to understand if a lack of adequate breaks is causing a decrease in job satisfaction among nurses. Methods: A quality improvement research study was conducted over 8 weeks and included 17 registered nurses. A 10-question survey was distributed via SurveyMonkey. Data Analysis: Microsoft Excel Data Analysis program and SurveyMonkey Analysis program were used for data analysis to quantify responses. Results: Over 50% of the nurses surveyed do not have mandatory breaks during their 12-hour shifts. 94% of nurses are feeling some degree of burn out at their current jobs, with 76% of those nurses either contemplating leaving or undecided if they will leave. Conclusion: The survey was able to identify that most nurses working 12-hour shifts in an acute care setting do not get adequate breaks. The cause of the lack of breaks was not studied; however, it showed that almost all the nurses surveyed were feeling burned out and a little more than half are contemplating leaving their jobs. There was a significant amount that said receiving mandatory breaks during their shift would improve the burn out they are facing.

Hand hygiene compliance in the intensive care unit: Hand hygiene and glove changes

Hand disinfection (HD) is known to be the single most effective prevention measure to avoid nosocomial infections, but the compliance rate (CR) remains low. The aim of this study was to determine the incidence of HD opportunities and the CR during the treatment of critically ill patients. One special focus was on glove usage to determine whether gloves were substituted for HD. This is a single-blinded direct observation of employees of an.ßintensive care unit. One specially educated observer recorded all hand hygiene indications over a period of 21 8-hour shifts as well as performed HD and study of glove use behavior. Over a period of 168.ßhours, 2,036 HDs should be performed during the care for 1 intensive care unit patient. In total, only 690 HDs occurred, resulting in a CR of 33.9%. With regard to the nurses, there was an HD opportunity around the clock every 6.ßminutes on average. About 17% of the total working time would have to be applied for 100% correct hand hygiene application. Donning or changing of gloves took place in 38.2% of all indications for HD. Our results show that HD opportunities occur in high frequency during the treatment of critically ill patients. The compliance with HD remains too low, even when a 100% CR seems to be unachievable. Improvements should focus on aseptic procedures, combining the lowest CR with the highest procedural risk for the patient. The Healthcare Personal (HCP) uses gloves when an HD opportunity occurs. Implementing glove disinfection strategies in daily routine might help optimize patient care.

A Blue-Enriched Light Intervention Counteracts the Alertness Decrement Among Mine Workers on Extended 12-Hour Night Shift Periods.

The aim of the study is to assess whether a blue-enriched light intervention improves nocturnal alertness and daytime sleep of night workers. Thirteen miners performing 12-hour night shifts for 12 consecutive nights were exposed to a baseline and a blue-enriched light condition. All subjects wore an actigraph and completed a Psychomotor Vigilance Task at the beginning and at the end of each shift. Data were analyzed with linear mixed models. In the blue-enriched light condition, the daily increase in median reaction time (RT), mean RT, slowest 10% of RT, and fastest 10% of RT was lower than that observed in the baseline condition between day 1 and 12 ( P ≤ 0.05). The addition of blue-enriched light during a long period of extended night shifts counteracts most of the daily decline in nocturnal alertness observed in the standard lighting condition, irrespectively of sleep duration and sleep efficiency.

Interventional Effect of Quiet Time Protocol on the Physiological Parameters of Premature Neonates Admitted to the Neonatal Intensive Care Unit

Background: Premature neonates are a group of high-risk patients who need intensive medical care and hospitalization in the neonatal intensive care unit (NICU) for their survival. In the NICU environment, there are highly stressful stimuli that have a negative effect on the physiological parameters of premature neonates. One of the interventions that improve the physiological parameters of neonates is the implementation of the quiet time protocol. Objectives: The present study aimed to investigate the effect of the quiet time protocol intervention on the physiological parameters of premature neonates admitted to the NICU. Methods: This quasi-experimental study was performed on 62 premature neonates selected through a convenient sampling method out of the neonates admitted to the NICU. First, the samples of the control group were collected. A demographic data questionnaire was employed. Neonates in the two groups were examined for 60 min during three phases before, during, and after the intervention in the evening shift of 15 - 17 o’clock. Data were analyzed using the SPSS software version 22 by the chi-squared test, repeated measures analysis of variance (ANOVA), and t-test. P-value < 0.05 was considered statistically significant. Results: The results of repeated measures ANOVA regarding arterial blood oxygen saturation (SaO2) percentage showed that changes over time were significant (P < 0.001). There was also a significant difference between the groups in terms of intervention effect (P = 0.004). In other words, the changes in SaO2 percentage were not the same in the two groups, and the changes in the score of the intervention group were higher than the control group. The results of repeated measures ANOVA showed that the changes in the heart rate and respiratory rate over time were significant (P < 0.001). Conclusions: The quiet time protocol is effective in reducing environmental stimuli and improving physiological parameters. Therefore, the implementation of these procedures during each 8-hour shift, that includes a specific period which light, sound, and bedside stimulation is controllably reduced, is recommended as a standard of care to reduce stress and improve the growth and development of premature neonates in the NICU.

Comparison of problems related to 12 and 24-shift shift work in emergency medical technicians of Ardabil province

Introduction: Shift work is one of the factors affecting the performance of employees in the field of health care, which can have important effects on their health. The present study was conducted to compare the problems related to 12 and 24-hour shift work among emergency medical technicians in Ardabil province.
 Materials and Methods: The present study was descriptive-analytical research that was conducted on 157 technicians from 115 urban emergency centers in Ardabil province who were selected by census method in 2018. The data collection tool was standard shift work (SSW) questionnaire. The data were analyzed through SPSS version 20 software and using descriptive statistics and a chi-square test.
 Results: The results showed that the physical and mental workload of emergency medical technicians working 12-hour shifts is higher than that of 24-hour shift workers. Also, the willingness of 12-hour shift workers to continue working according to the productivity improvement law was significantly more than urban 24-hour shift workers (P<0.001). 24-hour shift technicians had more time for personal life compared to 12-hour shift workers (P=0.008). Feeling tired during the day, stomachache and heartburn, and back pain were relatively common problems among all emergency medical workers.
 Conclusion: Considering that the physical and mental workload of 12-hour shift workers is more than 24-hour shifts, it is recommended that managers should prioritize the work schedule of emergency medical technicians, including reducing their working hours.

Work stress among physicians, dubai health authority, in the year 2018-2019

Background: Work stress is a significant problem that affects physicians. Multiple sources can contribute to this problem. High-stress rates among physicians can manifest in various expressions, including cognitive, behavioral, and somatic expressions. Work performance and quality of medical care administered to patients can be undermined by over-stressed physicians. The study aimed to assess the prevalence of stress among physicians working in governmental health facilities in Dubai (2018-2019) and their relationship with socio-demographic and job factors. Methods: It is a cross-sectional study. This study population includes all physicians practicing in Dubai Health Authority hospitals and primary health care centers in the Year 2018-2019. Target Number is 1337 taken from the registry of Dubai health authority administration, but only 668 questionnaires were included with a RR of 49.9%. The data tool used in this study is a modified self-administered questionnaire from both validated health and safety executive (Barbaranelli et al., 2018) occupational stress and stress questionnaire by International Stress Management Association UK 2013. It consists of 22 items which were divided into demographic, stress indicators, factors, and other domains. They were distributed as hard copies by hand. Findings: The study concluded that 40.2% were more likely to experience stress, while 59.8% were most prone to stress. Furthermore, the study showed a strong association with different factors such as the role of managers, shift duty, and multi-task work. Conclusion: Work stress is a prevalent problem among physicians working at Dubai health authority. The stress is associated with factors: such as multi-task work, shift hours’ duties, time pressure, and the role of line manager. Implications for Occupational Health Nursing Practice or Implications for Occupational Health Practice: Healthier working environment will promote the well-being of its staff and ensure the proper delivery of care to the community.

Viewpoint

Viewpoint

Effects of supra high-intensity interval training in police officers.

The job environment of a police officer involves unusually high physical and mental stressors paired with hours of prolonged sedentary behavior. The availability of police officers to engage in traditional regularly-scheduled exercises is generally restricted by irregular shift hours. Therefore, supra high-intensity interval training (supra HIIT) may be a viable training option as it elicits physical and mental health benefits and a training session can be completed in less than five minutes. Twenty-two police officers (37±8 years) performed 4-minute all-out sessions over 9 weeks. An average of 4±1 supra HIIT workouts was completed per week. Program assessment questions resulted in an overall program satisfaction level of 8.6 on a scale of 10 with very high enjoyment (94%) among the participants. Following the intervention, body fat percentage and fat mass decreased (P=0.003 and 0.028) and muscle mass increased (P=0.002). Arterial stiffness and total cholesterol concentration decreased (P<0.05). Maximal oxygen consumption increased (P=0.010). Wingate anaerobic power and mental and physical health did not change significantly. A supra HIIT program was highly satisfactory and enjoyable to police officers and was accompanied by a number of favorable effects on body composition, aerobic fitness, and arterial stiffness.

The Roth Net at 40 years: celebrating the spirit of innovation

The Roth Net at 40 years: celebrating the spirit of innovation

The Relationship Between Depression, Anxiety, and Stress Levels and Eating Behavior in Emergency Service Workers.

Introduction It is seen that shift work causes various biological, psychological, and behavioral problems in individuals. This studyaimed to determine the eating attitudes and behaviors of health workers working in shifts in a stressful environment such as the emergency service and to examine the relationship between depression, anxiety, and stress levelsand eating behaviors (emotional eating, restrictive eating, and external eating) in terms of sociodemographic and clinical characteristics. Material and Methods Sociodemographic data form; Depression, Anxiety, and Stress Scale (DASS); and Dutch Eating Behavior Questionnaire (DEBQ) were used. The study sample consisted of 92 employees (doctor, nurse, emergency medical technician (EMT), medical secretary, and security, staff) who were actively on duty in the emergency department of Alanya Alaaddin Keykubat UniversityMedical Faculty Training and Research Hospital. Results In our study, when the eating behavior of emergency service workers was evaluated in terms of "emotional, external, and restricted eating" sub-dimensions,depression (p=0.043), anxiety (p=0.017), increased stress levels (p=0.002), being female (p=0.022), nurse-emergency medical technician profession (p=0.001), working in 24-hour shifts (p=0.001), and diet history (p=0.013) were associated with "emotional eating."In addition, an increase in depression levels (p=0.048), being single (p=0.015), working in 24-hour shifts (p=0.005), a decrease in age (p<0.001) with "extrinsic eating,"an increase in body mass index (BMI) (p=0.020) and waist circumference (p=0.049), and diet history (p<0.001) were associated with "restricted eating." Conclusions In our study, among the sociodemographic factors, being female, being single, working in 24-hour shifts, diet history, nurse-EMT profession, and undergraduate education level were found to increase the tendency to develop eating behavior problems. An increase in depression levels, being single, working in 24-hour shifts, and a decrease in age were associated with "extrinsic eating."There is a correlation between depression, anxiety, and stress scores and emotional eating scores. Additionally, we found significant correlations between body mass index, waist circumference, diet history, and restricted eating scores. In the approach to eating behavior problems, it is important to determine the individual eating behavior disorder. Due to the increased risk of eating behavior disorder in those who work in long shifts such as 24 hours, it will be possible to organize work programs and increase the quality of service.

Documentation and Nurses' Time Caring for Patients.

The nursing shortage is growing to dangerous levels and is impacting public safety. The health system is anticipated to need 1.1 million additional nurses by 2022. One-third of the nursing workforce will retire in the next 10 to 15 years. Research has shown that having more nurses to care for patients decreases patient complications and even death.1 Required nursing documentation has risen exponentially, with charting taking more nursing time than direct patient care. Unnecessary documentation is dangerous. Incentivizing hospitals to reduce charting waste will save lives and help nurses stay at the bedside.After being away from direct patient care for 10 years, I returned to the intensive care unit as a bedside nurse during the COVID-19 pandemic. I was overwhelmed by the sheer volume of required documentation fields. The research supports my observation. In 2017, a time-motion study found that 33% of the nurses’ shift was spent interacting with technology.2 In comparison, time spent with the patients accounted for only 22% of a 12-hour shift. No one goes into nursing to spend endless hours charting.The documentation requirements have outpaced the nursing profession’s value of integrity. For example, 5 nursing interventions were to be documented every 2 hours, creating an impossible reality. Many of the hundreds of fields were not meaningful or even used for data analysis or research. The waste was astounding when critically ill patients needed urgent care.We must challenge the longstanding nursing mantra “if care was not charted, it was not done.” Health care has reached a tipping point in quality improvement initiatives. The literature demonstrates that lower patient-to-nurse ratios improve patient care. The charting volume rises with every new clinical update, yet there is a reluctance to remove any documentation. I think hospitals’ fear of lawsuits and reduced reimbursement have created this reluctance.Highly reliable organizations standardize processes across hospital systems. Although this approach improves patient care, it complicates the process of minimizing required documentation. Filling out all the mandatory fields to document the prevention of hospital-acquired conditions, accreditation requirements, and specialty certifications such as stroke prevents nurses from directly caring for patients.Solutions to this problem are multifactorial, and innovative leadership strategies are needed for a culture change. The concept of exnovation needs a role in our health care system. Exnovation stops inefficient processes that are no longer working by removing waste.3 Reducing nursing documentation time should be a top goal in the United States to ensure patient safety. Organizations must produce outcomes highlighting strategies that keep nurses in direct patient care.4Additional strategies include block charting, especially for drip titration, and limiting new checklists. Block charting is supported by regulatory bodies such as The Joint Commission and facilitates easier charting while still providing proper patient care.5 Bedside nurses can collaborate with informatics and quality experts to create protocols that meet standards of care and save precious nursing time. The Institute for Healthcare Improvement has acknowledged that while documentation is supposed to improve patient safety, burdensome documentation has the opposite effect.4 Just because a new tool or checklist worked in one setting, it is not universally meaningful in all environments. Careful vetting of tools with an easy process to remove antiquated documentation fields is called for.A Gallup poll has rated nurses as the most trusted profession for the past 20 years.6 Nurses need the public’s support to get us back to patient care. We need a culture change that rewards organizations that increase nurses’ time caring for patients.

Visual-Motor Reaction Parameters as Indicators of Fatigue in Emergency Medical Personnel

Introduction: Factors of the work environment affect the functional state of the central nervous system of employees, which is manifested by changes in sensorimotor reactions. Professional tasks of emergency medical personnel during the COVID-19 pandemic determine high requirements for the stability of functional systems of the body. Objective: To study the influence of professional activities on the mobility of central nervous processes in ambulance workers. Materials and methods: The study was conducted at the Ryazan City Clinical Emergency Hospital in 2021. It included 44 ambulance workers (12 doctors and 32 paramedics), 12 men and 32 women with the mean age of 35.77 ± 3.39 years, working a 24-hour shift followed by 72 hours off. We studied parameters of the complex visual-motor reaction of the subjects including the average response times and the Whipple’s index using the “NS-Psychotest” computer complex equipped with the visual-motor analyzer. The data were analyzed using the Data Analysis ToolPak in Microsoft Excel 2007. Results: The established statistically significant increase in the average response time of ambulance employees by 60.75 ms (p &lt; 0.001) by the end of the work shift indicates changes in the functional state of the central nervous system caused by fatigue. The analysis of the dynamics of indicators between the beginnings of neighboring shifts revealed positive trends expressed by an average decrease in the response time by 77.67 ms (p = 0.002) and an increase in the Whipple’s index by 0.07 (p &lt; 0.0001) in most subjects after the regulated rest period, thus indicating the effectiveness of the processes of functional restoration of the central nervous system. Conclusions: By the end of the work shift, ambulance workers demonstrated increased average visual-motor reaction times. Age under 30 and 0–5-year work experience are risk factors for poor professional adaptation proven by a high proportion of the subjects with a statistical increase in the average reaction time during the work shift. Stabilization of the dynamics of inter-shift indicators when compared at the beginning of adjacent shifts indicates proper functional restoration of the central nervous system of emergency medical personnel during the 72-hour rest period.

Impact of Sleep Deprivation on Academic Performance of Nursing Students at CMH, Lahore

Objective: The objective was to establish a quantifiable link between sleep depression and GPA of nursing students. Study Design: This is a cross sectional, observational analytical study. Place and duration: It was conducted in CMH Lahore Institute of Nursing for a duration of 4 months. Methodology: A cross-sectional study was conducted at CMH Medical College, Lahore. A total of 41 willing students were included. After informed verbal consent, a predesigned questionnaire, adopted from similar studies, was used to obtain information regarding individual sleep hours, duty hours, perceptions regarding their sleep patterns and their GPA (academic performance). All the data was collected using Google Forms. The data was analysed using SPSS software. Results: A total of 41 participants were included in the study. The mean age of these participants was 19.76±0.97 years. Mean GPA was 3.44±0.21. Majority of the students believed that 12-hour shifts negatively impact their attention span in class (87.8 percent) and consequently their study routines (95.1 percent). A cumulative 82.9 percent of the participants felt that they needed more sleep for better patient safety and academic performance. Conclusion: The mean GPAs, sleep lengths, and wake/sleep times did not vary much within the sample population. However, apparent sleep quality and perceived tiredness varied significantly, with the respondents reporting a grave concern about patient welfare and future academic performance. Keywords: Sleep, sleep deprivation, GPA, performance.

Arctic Marine Geology and Geophysics cruise to the northern Svalbard Margin and the Yermak Plateau

From the evening of July 23rd to the morning of August 1st, the Department of Geosciences at UiT The Arctic University of Norway, arranged an educational cruise to the northern Svalbard Margin/Yermak Plateau (Figure 1) for the courses GEO-3144 and GEO-8144 (Marine geology and geophysics cruise). The main aim of the cruise was to introduce the students to work at sea, which included acquisition of marine geological data (acoustic data and sediment cores) and lab analyses of split gravity cores. The students worked 12-hour shifts during the cruise The cruise may be known as: IG19-3_AMGG

Implementation and Impact of Critical Care Pharmacist Addition to a Telecritical Care Network.

To describe the implementation of a TCC pharmacist into an established TCC network, classify interventions performed, and quantify cost avoidance generated through pharmacist interventions. Multicenter, observational cohort study and retrospective return on investment, performed between December 2019 and December 2021. Critically ill adult patients, admitted to an ICU located in any of our eight community hospitals (50 ICU beds) within a large, 25-hospital integrated healthcare system (563 ICU beds total) in the United States. The TCC pharmacist service was implemented in 8-hour shifts, initially available 5 days per week, then expanded to 7 days per week. Critical care pharmacist interventions were categorized by clinical type established utilizing American Society of Health-System Pharmacists benchmarking standards and the latest cost avoidance data. During the 2-year analysis period, TCC pharmacists documented 2,838 interventions generating $1,664,254 of gross cost avoidance and a return on investment of 4.5:1. It is feasible to implement a TCC pharmacist within an established TCC network. Our experience showed enhanced comprehensive care of critically ill patients located in community hospitals within a large, integrated healthcare system, demonstrated significant cost avoidance, and has led to other initiatives, including a collaborative clinical/operational partnership with Life Flight.

Simultaneous Bladder Drainage via Suprapubic and Urethral Catheters: Which Drains More Completely and Why?

Reconstructive urologists often place both a urethral and suprapubic catheter intraoperatively to prevent extravasation of undrained urine across anastomosis sutures. As no consensus exists on which catheter drains the bladder more completely, many surgeons leave one catheter to gravity drainage and cap the other postoperatively. We sought to identify differences in catheter urine outflow during dual bladder drainage with suprapubic and urethral catheters in postoperative urology patients. Urine output (UOP) from transgender men who underwent Stage II Phalloplasty with urethral lengthening was retrospectively reviewed. Both 16 French urethral and suprapubic catheters were placed to gravity drainage postoperatively. Urine output from each catheter was recorded separately, twice daily. Mixed model regression modeling tested for differences in urine output by time of day (day/night) and activity status (Bedrest: Postop Day 0-2, Ambulatory: Postop Day 3+). The aggregate number of 12-hour shift urine output observations was 250 (125 for urethral and 125 for suprapubic catheters) across 14 inpatients. Suprapubic catheters had a mean 410 ml higher output than urethral catheters per 12-hour shift (p=0.002; 95% CI: 185, 636 ml). During daytime, Suprapubic catheters demonstrated higher UOP than urethral catheters per 12-hour shift (Estimated Difference: 464 ml; p=0.002; 95% CI: 211, 718 ml). During nighttime, a similar phenomenon was observed (Estimated Difference: 356 ml; p=0.009; 95% CI: 104, 606 ml). When comparing mean UOP from each catheter during the Bedrest Phase, suprapubic catheters averaged an estimated 295 ml higher UOP compared to urethral catheters per 12-hour shift with a trend toward statistical significance (p=0.052; 95% CI -3, 594 ml). During the Ambulatory Phase, mean suprapubic catheter UOP was an estimated 472 ml higher than urethral catheters per 12-hour shift (p=0.009; 95% CI 142, 802 ml). Simultaneous bladder drainage with urethral and suprapubic catheters shows greater drainage from the suprapubic catheter (35% vs 65%). When using two catheters, both can be placed to gravity to maximize bladder drainage as the suprapubic catheter can drain residual urine not adequately drained by the urethral catheter.