Abstract
PurposeTo evaluate the outcomes from a Urology Nurse Practitioner (UNP)-led service for the initial assessment and diagnostic decision making and for suspected prostate cancer referrals.MethodsUsing a modified Delphi analysis approach, a panel of Urological Prostate Cancer specialists were asked to review the UNP management plans of a convenience sample of 60 randomly selected patient cases – between June 2012 and June 2015. The panel was required to establish consensus or identify divergence of clinical practice, based on five key statements. In addition, cost analysis, waiting time and patient satisfaction evaluation were made regarding the nurse-led service.ResultsIn 87% (52/60 cases), consensus was reached by the panel that the UNP management plan was entirely appropriate and in only two cases was there discordance, where the panel felt that the management plan by the UNP was inappropriate with errors potentially and significantly affecting the patient. Over the 3 years, a modest cost saving of £11,500.38 was realised, which due to increased referrals has now realised in 1 year (2017/18) a saving of £11,335.50. Compared to the previous physician-led service, waiting times for patient appointment fell by 52% over the 3-year period; 57/63 (90%) patients reported being satisfied with seeing a UNP instead of a doctor for their first appointment; 60/63 (95%) reported that, following the initial hospital visit with the UNP, they had a clear understanding of what the next steps were in their assessment. Overall, 54/63 (86%) were ‘very satisfied’ with the UNP-led service.ConclusionOur study demonstrates that a UNP approach to the assessment and management of suspected prostate cancer referrals provides an effective approach to care in an ever-demanding healthcare arena.Through a supported training programme, urology nurses can deliver a high standard of service.
Highlights
Accounting for almost 13% of all new cancer cases, prostate cancer is the second most common cancer in the UK
Through a supported training programme, urology nurses can deliver a high standard of service
To date, no published studies have presented the outcomes of a nurse-led outpatient clinic assessment approach for suspected prostate cancer referrals
Summary
Accounting for almost 13% of all new cancer cases, prostate cancer is the second most common cancer in the UK. There are around 47,700 new prostate cancer cases in the UK every year, averaging about 130 every day (2014–16) [1]. It is essential that we develop a workforce that is both sustainable and cost-effective, which has the appropriate clinical expertise and is multi-professional, in order to meet the growing complex needs of cancer patients [3]. The utilisation of highly skilled and competent Urology Nurse Practitioners (UNPs) has already demonstrated that nurse-led approaches can deliver safe and clinically effective aspects of care, with high levels of patient satisfaction and improved patient outcomes [4,5,6,7]. To date, no published studies have presented the outcomes of a nurse-led outpatient clinic assessment approach for suspected prostate cancer referrals
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