OBJECTIVE: To investigate the impact of a urological community nursing service on the mode of practice, efficiency, and quality of care in a urological practice. METHODS: A urological community nurse was appointed to investigate the possibility of performing various urological procedures in the community rather than in hospital, with a prospective audit of the results for a period of 1 year. The setting was a busy urological unit serving a mixed urban and rural catchment area of 300,000 people. The outcome was assessed by the number and type of procedures successfully transferred from hospital to community practice. RESULTS: In 1 year, 464 urological episodes were performed in the patients' homes which otherwise would have required transfer or admission to hospital for treatment or, in some cases, a cancelled operation. These episodes included tuition in clean intermittent self-catheterization and dilatation, changes and insertions of urethral, suprapubic and nephrostomy catheters, bladder instillations to treat cancer and interstitial cystitis, voiding trials with no catheter, urosheath fittings, and pre-operative visits and follow-up visits to avoid attendance at the clinic. CONCLUSIONS: The urological community nursing service transferred a significant number of routine urological procedures from hospital to community with considerable financial savings and improvement in the quality and efficiency of urological care.
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Grose et al. (1995) studied this question.