Nurse lead Prostate Screening and Assessment Clinic
Introduction
Patients with lower urinary tract symptoms (LUTS) relating to BPH constitute a heavy workload at the Urology Clinic of Surgical SOPD. In Hong Kong East Cluster (HKEC), patients with lower urinary tract symptoms (LUTS) referred to urology SOPD clinic face a long waiting time about 220 weeks. In order to assist urologist to judge whether the patient would need surgery for BPH or whether the patient as a high risk of prostate malignancy, a Nurse-led Prostatic Screening Clinic for BPH was need to set up in order to provide early assessment, investigation and management planning for these patients.
Objectives
The objective is to shorten the waiting time of patients with lower urinary tract symptoms (LUTS) for assessment to rule out severe obstruction and malignancy of prostate in order to provide proper management.
Methods
Patients referred to the SOPD for LUTS are screened, and interviewed by a urology nurse specialist- providing health education regarding BPH related problems. Assessment and investigation offered to patients including:
History Taking
IPSS
Urine x RM/C&ST+ Cytology
CBC, LFT, RFT & PSA
Flow Rate + PVR
KUB
All these results would be available and screening by urologist before patients had second visit to the prostatic screening clinic. This practice allowing a provisional diagnosis to be made; treatment plans to be discussed with patients by urology nurse and drug treatment to be offered in suitable cases.
Operation
Time & Place
One half day session on Thursday AM in SOPD per week
Manpower
1 APN specialized in urology (from Surgery) +1 trained GSA (from SOPD)
Equipment
One set of television + DVD player
Uroflowmetry + Bladder scan
Quota
For Prostate Screening and Assessment Clinic
10 New Cases + 10 Old Cases per session
(Total 20 patients in one AM session)
Recruit Criteria
-Patient with lower urinary tract symptoms referred by GP/GOPD/A&E
Retrospective review of patients attending nurse led prostate screening clinic was need to perform after implementation. All the investigation results collected from the prostate clinic including the no. of cases attended, the waiting time for the first consultation and how many cases need to require early medical treatment were being analyzed as the outcome measurement.
Workflow of Prostate Screening and Assessment Clinic
