Are specialist nurse‐led check flexible cystoscopy services as effective as doctor‐led sessions?

Abstract

ABSTRACTThe demands on service provision have led to an increasing number of check flexible cystoscopies being performed by urology nurse specialists as opposed to doctors. We aimed to compare the performance of urology nurse specialists, in a nurse‐led service, with doctor‐led sessions. Retrospective case note analysis was performed on patients who required further treatment following their check flexible cystoscopies. Data was collected in two separate 3‐month time periods: first (1 October 2012–31 December 2012) all cases that were performed by doctors, second (1 March 2013–31 September 2013) all cases that were performed by nurse specialists. Details recorded included the findings at check flexible cystoscopy, treatment and initial and subsequent histology results. A total of 137 episodes were included in the study (71 – nurse, 66 – doctor). Correct reporting at initial check cystoscopy with subsequent confirmation of TCC, CIS or dysplasia occurred in 99 of 137 (72.3%) of episodes (55 – nurse, 44 – doctor). Over reporting at initial check flexible cystoscopy with findings later showing any variant of inflammation/cystitis, reactive changes, atypia or no lesion occurred in 38 of 137 (27.7%) episodes (16 – nurse, 22 – doctor). The nurse‐led service correctly reported 55 of 71 (77.5%) episodes and over‐reported 16 of 71 (22.5%). The doctors correctly reported 44 of 66 (66.7%) episodes and over reported 22 of 66 (33.3%). This study provides evidence that nurse led check flexible cystoscopy sessions are comparable in quality to doctor‐led sessions and supports the use of these services. This has clear implications on the delivery of a cost effective service to meet current financial demands.