UROLOGICAL COMMUNITY NURSING - A NEW CONCEPT IN THE DELIVERY OF UROLOGICAL CARE

Objective To investigate the impact: of a urological community nursing service on the mode of practice, efficiency, and quality of care in a urological practice. Methods A urological community nurse was appoint ed to investigate the possibility of performing various urological pro cedures in the community rather than in hospital, with a prospective a udit of the results for a period of 1 year. The setting was a busy uro logical unit serving a mixed urban and rural catchment: area of 300 00 0 people. The outcome was assessed by the number and type of procedure s successfully transferred from hospital to community practice. Result s In 1 year, 464 urological episodes were performed in the patients' h omes which otherwise would have required transfer or admission to hosp ital for treatment or, in some cases, a cancelled operation. These epi sodes included tuition in clean intermittent self-catheterization and dilatation, changes and insertions of urethral, suprapubic and nephros tomy catheters, bladder instillations to treat cancer and interstitial cystitis, voiding trials with no catheter, urosheath fittings, and pr e-operative visits and follow-up visits to avoid attendance at the cli nic. Conclusions The urological community nursing service transferred a significant number of routine urological procedures from hospital to community with considerable financial savings and improvement in the quality and efficiency of urological care.