Urology ward attenders: auditing a nurse-led service

This audit describes a urology walk-in service where patients are treated on the acute urology ward. Any patient previously known to the urology department or undergoing urology treatment can contact the ward 24 h a day for management of urology-related issues. The service is nurse led and has evolved to become known as a 'ward attender' service. The audit is designed to observe how many patients present over a 12-month period and the type of conditions seen. The aim is to see what effect this service has on the ward, its resources and primary care. The notes of ward attenders presenting to the urology ward over a 12-month period were retrospectively analysed. Data collected included source of referral, types of urology conditions seen and treatment provided. Patients were divided in to two groups based on either planned (elective) or unplanned (emergency) attendance. Attenders were given questionnaires to obtain patient opinion on various aspects of service provision. Four hundred and four patients presented to the urology ward for review and treatment in one calendar year. These patients were seen by nursing staff and 21 other patients were reviewed by doctors. Ten patients required admission following review. Emergency attendances included patients with blocked nephrostomy tubes; haematuria, urinary retention or sepsis following endoscopy and catheter-related issues. Elective attendances included patients requiring bladder washouts, change of catheter and instructions for intermittent self-catheterization. This service helps forge a close working relationship with general practitioners, community nurses and nursing homes, by accepting direct referrals from them. Patients presenting as ward attenders comment that the service is rapid and that by being seen by more familiar staff, trust and confidence is built. By introducing this service, we feel we are contributing to the changes in the way urology patients are managed in the National Health Service.