Development and implementation of a nurse-led chronic disease management clinic in the urology department of a tertiary hospital: a descriptive study

To describe the development, implementation, and routine operation of a nurse-led chronic disease management clinic in the urology department of a tertiary hospital. A nurse-led chronic disease management clinic was established in July 2024 within the hospital’s existing specialty nursing outpatient service framework. The clinic model included staffing and qualification requirements, professional training, defined nursing responsibilities, physician–nurse collaboration, standardized service procedures, information system support, and quality management. The clinic primarily focused on the long-term management of patients with prostate and bladder cancer, while also providing specialty nursing services to patients with other urological conditions according to their care needs and the authorized scope of nursing practice. Services comprised four components: (1) patient assessment and follow-up planning; (2) treatment follow-up and adverse event monitoring; (3) rehabilitation guidance and health promotion; and (4) healthcare policy assistance and basic nursing care. Nurses provided care within their authorized scope of practice, while urologists were involved in medical assessment and treatment decisions when required. A single-center retrospective descriptive study was conducted using routinely collected service records to describe clinic activities and patient management. From July 2024 to September 2026, the clinic recorded 14,013 outpatient registrations, with total registration fees of CNY 152,758. Monthly registrations increased from 147 in July 2024 to a peak of 710 in August 2026, with fluctuations over the study period. Specialty nursing services included 14,246 prostate cancer-related injections, 3,523 urinary catheterizations, 2,777 intravesical instillation procedures, and 2,142 urinary catheter removals. The clinic also assisted patients with prostate or bladder cancer in applying for outpatient chronic and special disease insurance benefits. The follow-up management system recorded 1,111 patients, of whom 953 had been followed up and 951 had successful follow-up records. A total of 3,553 follow-up tasks were executed, of which 3,547 were successful, corresponding to a task-level success rate of 99.83%. A nurse-led chronic disease management clinic was established and operated within the urology department of a tertiary hospital, with defined nursing responsibilities, physician–nurse collaboration, and standardized service procedures. This study describes the clinic’s organizational structure, service delivery processes, and routine service activities, providing a practical reference for the development and implementation of similar outpatient nursing services. Further research is needed to evaluate the clinical outcomes and economic implications of this service model.