Grose K, Brooman P J, O'Reilly P H
Department of Urology, Stepping Hill Hospital, Stockport, UK.
Br J Urol. 1995 Oct;76(4):440-2. doi: 10.1111/j.1464-410x.1995.tb07741.x.
To investigate the impact of a urological community nursing service on the mode of practice, efficiency, and quality of care in a urological practice.
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.
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.
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.
探讨泌尿外科社区护理服务对泌尿外科诊疗模式、效率及护理质量的影响。
指定一名泌尿外科社区护士，研究在社区而非医院开展各种泌尿外科操作的可能性，并对1年期间的结果进行前瞻性审核。研究地点是一个繁忙的泌尿外科科室，服务于一个涵盖30万城乡人口的混合区域。通过成功从医院转移至社区诊疗的操作数量及类型来评估结果。
1年内，在患者家中进行了464例泌尿外科诊疗，否则这些患者需要转院或住院治疗，在某些情况下甚至需要取消手术。这些诊疗包括清洁间歇性自我导尿和扩张的培训、尿道、耻骨上和肾造瘘导管的更换与插入、用于治疗癌症和间质性膀胱炎的膀胱灌注、无导管排尿试验、尿道鞘装置，以及术前访视和随访以避免患者前往门诊。
泌尿外科社区护理服务将大量常规泌尿外科操作从医院转移至社区，节省了大量资金，并提高了泌尿外科护理的质量和效率。
