Background Last-minute cancellations in urological surgery are a global issue resulting in wastage of resources and delays to patient care. In addition to non-cessation of anticoagulants and inadequately treated medical comorbidities, untreated urinary tract infections (UTIs) are a significant cause of last-minute cancellations. This study aimed to ascertain whether the introduction of a specialist nurse clinic resulted in a reduction of last-minute cancellations of elective, urological surgery as part of our elective recovery plan following the COVID-19 pandemic. Methods A specialist urology nurse-led clinic was introduced to review urine culture results preoperatively. Specialist nurses contacted patients with positive urine cultures and their general practitioners by telephone and email to ensure a minimum of 2 days of “lead-in” antibiotics were given prior to surgery. Patients unfit for surgery were postponed and optimised, and vacant slots were backfilled. A new guideline was created to improve timing and structure of the generic preassessment. Results Between 01/01/21 and 30/06/21, a mean of 40 cases were booked each month, with average cancellations rates of 9.57/40 (23.92%). After implementing changes on 01/07/21, cancellations fell to 4/124 (3%) for the month. On reaudit there was a sustained and statistically significant reduction in cancellation rates: between 01/07/21 and 31/12/21 cancellations averaged 4.2/97.5 (4.3%, p<0.001). Between 2 and 9 (2-16%) patients each month were started on antibiotics, while another 0 to 2 (0-2%) were contacted for other reasons. Conclusion The implementation of a specialist urology nurse-led preassessment clinic resulted in a sustained reduction in cancellations of last-minute elective urological procedures.
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