Developing and centralising a nurse-led local anaesthetic transperineal biopsy service during COVID
- PMID: 37818022
- PMCID: PMC10560612
- DOI: 10.1002/bco2.251
Developing and centralising a nurse-led local anaesthetic transperineal biopsy service during COVID
Abstract
Introduction: Transperineal (TP) biopsy has recently replaced the transrectal ultrasound (TRUS) approach as the ideal method of biopsy in the United Kingdom with growing trends to adopt. To minimise transmission of COVID-19 during the first wave of the pandemic, the British Association of Urological Surgeons Section of Oncology issued guidelines reducing general anaesthesia (GA) procedures and initiate COVID-secure 'green' site diagnostics. As a result of these guidelines and reduction in clinical diagnostics trust-wide, we ceased all TRUS diagnostics and implemented a centralised, nurse-led LA TP biopsy service.
Materials and methods: A waiting list was developed for those awaiting prostate cancer diagnostics across the network. A COVID-secure 'green' site was quickly identified with TP biopsies starting soon after. Quality improvement methodology was utilised and a run chart was used to show if changes were sustainable.
Results: Successful implementation and centralisation of a TP biopsy service occurred with TRUS guided biopsies ceasing across all sites on 12 May 2020. The procedures were carried out by urology advanced nurse practitioners under local anaesthesia with a select few occurring under GA. Centralising the service in a COVID-secure manner freed up dedicated theatre sessions and personal leading to increased efficiency elsewhere. The service was robust and was maintained upon lifting of COVID restrictions.
Conclusions: A centralised, nurse led LA TP biopsy service in a procedural unit was implemented successfully. The service has remained resilient upon lifting of restrictions and return to business as usual. This led to improved performance across trust by freeing up valuable resources and staff to undertake more duties. The service remains highly valued trust-wide.
Keywords: COVID‐19; advanced nurse practitioner; biopsy; prostate cancer; quality improvement; transperineal; transrectal.
© 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.
Conflict of interest statement
None.
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References
-
- Tamhankar AS, El‐Taji O, Vasdev N, Foley C, Popert R, Adshead J. The clinical and financial implications of a decade of prostate biopsies in the NHS: analysis of Hospital Episode Statistics data 2008–2019. BJU Int. 2020. - PubMed
-
- Ahmed HU, Bosaily AE, Brown LC, et al. Diagnostic accuracy of multi‐parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017;389(10071):815–22. - PubMed
-
- Grummet JP, Weerakoon M, Huang S, et al. Sepsis and ‘superbugs’: should we favour the transperineal over the transrectal approach for prostate biopsy? BJU Int. 2014;114(3):384–8. - PubMed
-
- Cowan T, Baker E, McCray G, Reeves F, Houlihan K, Johns‐Putra L. Detection of clinically significant cancer in the anterior prostate by transperineal biopsy. BJU Int. 2020;126:33–7. - PubMed
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