Authors (including presenting author) :
Kung WC(1), Lau KY(1), So WL(1), Lui KL(1), Sy YW(1), Yu MH(1), Wong KC(1), Chau KF(1), Li SK(1), Wong KW(1), Chan NH(1), Li CM(1), Tang CN(1)
Affiliation :
(1)Department of Surgery, Pamela Youde Nethersole Eastern Hospital
Introduction :
Benign prostatic hyperplasia (BPH) affects more than half of all men aged over 60 years, and up to 90% of men aged over 80 years. Progressive enlargement of the gland may cause significant obstruction of the urethra and interfere with the normal flow of urine. Transurethral resection of prostate (TURP) is often recommended when BPH causes troublesome symptoms and fails to respond to treatment with medication.
Most of the patients for TURP are in advanced age or with different medical comorbidities. The change of their medical or physical conditions may result in cancellation of the operation. As a result, a nurse initiated screening service cooperated with urologists was set up in January 2019 to provide earlier pre-operative screening for those patients.
Objectives :
The objective is to evaluate the impact of new service in management of patients with BPH required surgical treatment.
Methodology :
A new operating protocol for BPH patients and the streamlining workflow has been commenced in January 2019. Patients eligible for TURP are chosen by urologist & the screening service is initiated and performed by urology nurses. A video of TURP surgery was showed to patient and their families with briefly explanation. Prostate size of each patient was also measured with pre-op education given. Besides that, it also conducted the screening on patient’s medical history on determine the necessary of seeking medical assessment pre-operatively in order to optimize the medical condition of the patient before surgery.
Result & Outcome :
A total of 220 patients were undergoing nurse initiated screening service since January 2019. Compared with patients before the service, the cancellation rate of TURP reduced from 2.2% to 1.1%, and the utilization rate of operation theatre for TURP surgery was increased from 88.6% to 97.6%. In addition, the waiting time for TURP patients can be shortened from 6 weeks to 3 weeks. Moreover, with the better screening of patients’ condition before surgery, the mean length of stay for TURP patients was reduced from 2.58 days to 2.3 days, and the unplanned admission rate decreased from 9.7% to 4.7%.
