Integrated Model of Specialist Outpatient (SOP) Service through Surgical Nurse Clinic (Urology) for Patients with Lower Urinary Tract Symptoms is a way toward our future Urology Services

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Authors (including presenting author) :
Leung KK, Lam MK, Ho YK, Lau SY, So HS, Chow TL
Affiliation :
Surgery Department, United Christian Hospital
Introduction :
Integrated Model of Specialist Outpatient Service through Nurse Clinics were established in October 2018 for 4 specialties of 7 Cluster hospitals. Urology nurse clinic is one of the participated specialty in UCH. Lower Urinary Tract Symptoms and Begin Prostate Hyperplasia are most common problems and diseases in urology specialty. Patients with LUTS problems need to wait for a long time (> 160 weeks) for the first consultation of urology in UCH. The new LUTS assessment clinic was launched on October 2, 2018 in UCH. We provide quality urological nursing care and early intervention to our patients.
Objectives :
(1) To design a new protocol to manage the high volume disease with quality care. (2) To provide a fast track service for the high risk patients to receive the early intervention.
Methodology :
Male with LUTS problems was referred to our urology clinic. The referrals are screened by the urologist then referred to the pilot program of IMSN-LUTS assessment nurse clinic. It included the pre-consultation workup services and prostate triage services. The urology nurses provide timely assessment, counselling and intervention to patients based on management protocols. If patients with abnormal investigations such as elevated PSA, urinary retention or urinary infection are found, they will be referred to urologist with appropriate prompt arrangements.
Result & Outcome :
From October 2, 2018 to December 27, 2018, total 203 new cases with aged 41 to 92 years (71) attended to the IMSN-LUTS assessment clinic. 37 (18%) were received the workup services. Urology nurse provided the appropriate health education and counselling to the patients. It can help the urologist to treat the patient more efficiently. 166 (82%) were received the prostate triage services, 27 (16%) patients had abnormal investigations and fast track appointment were arranged. The waiting time for this patients group was shortened from 115 weeks to 24 weeks after urology nurse assessment. The lifestyle modification and nursing intervention will have provided to the low risk patients. A total of 43 patients were reviewed during the study period, and 30 (70%) patients had better control of lower urinary tract symptoms. IMSN can contribute the collaboration of the clinical specialists and specialty nurses to manage growing service demands. The LUTS assessment nurse clinic plays a crucial role in triaging the high risk patients with abnormal findings. It providing fast track management of those patients and early assess to specialist care and intervention. It also provides the effective first line management for the patients with Lower Urinary Tract Symptoms.

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