Clinical & Medical Case Reports

Aim: To analyse and compare the number of patients who underwent urodynamic tests before and aft er the introduction of nurse-led urodynamic clinic and assess staff ’s adherence to local policy.

 

Background: Urodynamics tests (UDT) are physiological measurements of the voiding and storage function of the lower urinary tract that are commonly performed in clinical practice to investigate bothersome lower urinary tract symptoms. Despite considerable eff orts to improve UDT, standardization of the practice remains challenging. Th e International Continence Society (ICS) continues to urge for “Good Urodynamic Practice”. Hence, we introduced a nurseled urodynamic clinic (NLUC) to improve effi ciency and patient experience.

 

Methods: Urodynamics clinic patient database was used to identify the patients who underwent UDT between October 2017 and June 2019. The first cycle included retrospective data of 82 randomly selected patients between September 2017 and September 2018. The NLUC was introduced in November 2018. The data of 86 patients who underwent UDT after the introduction of NLUC were assessed and analysed retrospectively.

 

Results: The average number of patients undergoing UDT was 25 per month with inconsistent referrals that are lacking important information such as significant comorbidities, predisposing factors, findings of the clinical examinations, and urinalysis results. 23/82 (28%) patients were not commenced on appropriate treatment and only 12/82 (≈15%) had bladder diary charts completed. Findings concluded that up to 25% of referrals were deemed inappropriate for UDT. After the introduction of NLUC the average number of patients decreased to 18.8 and 91.1 of patients had a fi nal diagnosis or appropriate management plan aft er UDT.

 

Conclusion: Not only has the introduction of NLUC reduces same-day cancellations in patients undergoing UDT, but also decreases the burden on our department and off ers patients education, providing better overall experience.