The nurse cystoscopist: a feasible option?

Abstract

Objectives To compare the accuracy achieved by a trained urology nurse practitioner (UNP) and consultant urologist in detecting bladder tumours durinḡ exible cystoscopy. Patients and methods Eighty-three patients underwent exible cystoscopy by both the UNP and consultant urologist, each unaware of the other's ®ndings. Before comparing the ®ndings, each declared whether there was tumour or any suspicious lesion requiring biopsy. Results Of 83 patients examined by¯exible cystoscopy, 26 were found to have a tumour or a suspicious lesion. One tumour was missed by the UNP and one by the urologist; each tumour was minute. Analysis using the chance-corrected proportional agreement (K) was 0.94, indicating very close agreement. Conclusion A UNP can be trained to perform cystoscopy and detect suspicious lesions as accurately as can a consultant urologist. Legal and training issues in implementation are important.

The practice of the first check cystoscopy following radiotherapy for the treatment of muscle-invasive (T3N0M0) bladder cancer: a UK national survey

“…Interestingly, studies have shown that UNPs were able to obtain as accurate results in cystoscopy as consultant urologists [17]. In a study conducted in Sweden, Fagerberg and Nostell demonstrated that competent and well-trained UNPs can deliver a similar flexible cystoscopy service to that usually carried out by consultant urologists [18].…”

Advanced urology nursing practice

“…In addition, they are often responsible for any subsequent intravesical therapy and can, therefore, be involved in all aspects of bladder cancer management. Patients respond positively to having a single contact for any ongoing concerns, 23,24 and appreciate telephone calls to follow-up on their progress, discuss their management plan, and offer counselling services. 25 Clinical outcomes have been examined for nurse cystoscopists, with almost complete agreement between the cystoscopy findings of nurses and urologists training in cystoscopy.…”

“…25 Clinical outcomes have been examined for nurse cystoscopists, with almost complete agreement between the cystoscopy findings of nurses and urologists training in cystoscopy. 24,26 One concern is that nurses might have a lower threshold for referring patients for general anaesthetic cysto scopy to further investigate any abnormalities identified at surveillance cystoscopy compared with medical staff, potentially increasing the cost of the service. 26 However, the higher referral rate might simply reflect the learning curve of novice nurse cysto scopists, and other audits have reported equivalent referral rates between nurses and urology personnel.…”

“…26 However, the higher referral rate might simply reflect the learning curve of novice nurse cysto scopists, and other audits have reported equivalent referral rates between nurses and urology personnel. 23,24 The introduction of a nurse-led surveillance cysto scopy programme at a tertiary institution in Australia in 2008 has been shown to free up the time of medical staff, who can then perform a greater number of diagnostic cystoscopies, resulting in a 72% reduction in the number of patients waiting for these procedures. 27 As nurses gain experience in performing cystoscopies, and gain the trust of their medical colleagues by achieving comparable outcomes, the role of nurse cysto scopists is already growing.…”

Nurse‐led cystoscopy: the next step

“…Recent reports have suggested that adequately trained urology nurse practitioners can undertake FC as accurately as can a consultant urologist [3]. The benefit from this is only partly realised if any further management rests with the consultant.…”