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.
Purpose The aim of this research was to create a novel and low-cost TP prostate biopsy simulator that has face, content and construct validity with high educational value. Methods This research developed a trans perineal prostate (TP) biopsy simulator using 3D-printed moulds and tissue-mimicking materials. Important regions (anterior, mid, and posterior zones) were coded with different colours. Ultrasound visible abnormal lesions were embedded in the prostate phantom. Expert and novice participants in TP biopsies were recruited. Essential skills were identified through the consensus of six experts. These skills were assessed through tasks performed by participants. This included the accuracy and timing of systematic and target biopsies. Immediate feedback was determined by the colour of the biopsy cores taken. A survey was distributed to evaluate its realism and educational value. Results The material cost of one simulator was £7.50. This simulator was proven to have face, content, and construct validity. There was a significant difference ( p = 0.02) in the accuracy of systematic biopsies between both experts and novices. Significant difference was also observed ( p = 0.01), in accurately identifying target lesion on ultrasound between both groups. Participants rated the overall realism of the simulator 4.57/5 (range 3–5). 100% of the experts agreed that introducing this simulator to training will be beneficial. 85.7% of the participants strongly agree that the simulator improved their confidence in TP biopsies. Conclusion There is value in integrating this proof-of-concept TP prostate biopsy simulator into training. It has highly rated educational value and has face, content, and construct validity. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-023-04387-y.
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