A Collaborative Approach to Implementing Blue Light Cystoscopy

Abstract

<h3>Background Information</h3> White light cystoscopy and urine cytology is standard procedure to diagnose non-muscle invasive bladder cancer (NMIBC). Recurrence rates remain high with this method. Early recurrence in patients with NMIBC may be the result of previously undetected lesions during transurethral resection of bladder tumor. Blue light cystoscopy (BLC) with Hexaminolevulinate (Cysview) has shown to improve tumor detection of NMIBC (Daneshmand et al 2018). The Urology Team received approval from senior leadership to bring BLC to our facility. <h3>Objective of Project</h3> To successfully implement the new Blue Light Cystoscopy program through the collaboration, education, and preparation of all stakeholders. <h3>Process of Implementation</h3> The stakeholders identified were: Urologists, Ambulatory Surgery nurses who would care for the patient pre-op and instill the Cysview, Pharmacy that had to deliver the Cysview, Central Supply providing catheter equipment, Operating Room (OR) nurses who had to be competent with the equipment, and the Schedulers who had to book these cases after the first case of the day. The project leaders, one from the OR and one from the Preoperative Unit, met weekly to formulate and implement a plan. The project leaders collaborated with each stakeholder and kept the team apprised of the progress. Once the specialized OR equipment was in place, the education was rolled out to all parties via hands on sessions, educational handouts, process discussions, and demonstrations by equipment representatives, to ensure all personnel were ready to implement BLC. <h3>Statement of Successful Practice</h3> Four months after the Urologists request, the first BLC was performed. The whole process from booking, pre-operative care to the operating room and discharge went smoothly. The new BLC with Cysview procedure was successfully implemented with physicians, pre-op nurses, OR nurses, pharmacists, central supply, and schedulers because of the collaborative approach to training and support. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> The identification and inclusion of all stakeholders at the beginning of this project, and communication throughout the process, ensured all issues and perspectives were identified and addressed. Through education and support, success of the new BLC with Cysview procedure was implemented seamlessly.