Efficacy of a Urology Nurse-led Clinic in Queen Mary Hospital of Hong Kong

Abstract

INTRODUCTION AND OBJECTIVES: Patients with common urological problems need to wait for a long time (>248 weeks) before they have the first consultation in Queen Mary Hospital of Hong Kong. In order to enhance patients’ care, a Urology Nurse-led Clinic was started in April 2010 to provide service to patients with three common urological problems, namely lower urinary tract symptoms (LUTS), loin pain and microscopic haematuria. METHODS: All urology new case referrals are screened by the Advanced Practice Nurse in the Centre. Suitable patients are invited to attend the Urology Nurse-led Clinic. Patient education materials and management protocols of the common urological problems are developed. The nurses provide timely assessment and counselling to patients involved according to management protocols. If patients with abnormal investigations such as elevated PSA, abnormal ultrasound findings or severe BPH requiring operation are found, they will be referred back to urologist with appropriate fast track arrangement. Regular audits are conducted on the service process and outcome for continuous quality improvement. RESULTS: A total of 1105 patients were seen in urology nurse-led clinic from April 2010 to June 2011. 81.6% of these patients were male and 18.4% were female. 80.2% of patients were discharged directly from the nurse-led clinic after assessment and counselling, 62.5% of which were referred to family physicians and 17.7% do not require any follow-up. Only 19.8% of patients required referrals to urologist for further intervention. The urology new case waiting time in Queen Mary Hospital dropped from 263 weeks (2Q2010) to 61 weeks (2Q2011). 9 patients had early cancer detection with prompt surgery or radiotherapy done. And, 63 patients had fast track surgery done for the irritative urological symptoms. CONCLUSIONS: The Urology Nurse-led Clinic play a crucial role in shortening the new case waiting time and providing fast track management of those patients requiring intervention. With the supports from urology consultants and family physicians, majority of these patients can be discharged to the community, which further reduce unnecessary pressure on hospital services.