A closed looped audit: Reducing catheter-related morbidity and improving TURP waiting times in line with GIRFT recommendations
BAUS ePoster online library. Lam A. 11/10/20; 304200; P8-6
Ms. Angela Lam
Ms. Angela Lam
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A closed looped audit: Reducing catheter-related morbidity and improving TURP waiting times in line with GIRFT recommendations

Lam A1, Saaid S1, Wong K1, Nitkunan T1
1Epsom and St Helier University Hospitals NHS Trust, United Kingdom

Introduction:
In July 2018, Getting It Right First Time (GIRFT) recommended improved pathways for patients awaiting a TURP and in particular, the morbidity associated with catheterised patients. We reviewed a cohort of patients who underwent a TURP.

Methods:
All patients who underwent a TURP from 1 January 2018 to 31 December 2018 were included. Data was collected on waiting list times, whether a catheter was inserted, date of catheter insertion, Accident and Emergency (A&E) attendances for catheter-related issues and the number of admissions this resulted in. We made a change in our pathway to ensure that catheterised patients undergo a TURP within 30 days of waitlisting. We re-audited data from 1 November 2019 to 31 December 2019.

Results:
181 patients underwent a TURP in 2018; 65 were catheterised with 10/65 performing self-catheterisation. The median waiting list times for the catheterised patients and non-catheterised patients were near identical (118 v 119 days). 93/95 A&E attendances were in the catheterised cohort. The median number of A&E attendances was 1 (range 0-8), the first attendance 1-day post-catheterisation with the median being 20 days (range 1-618). There were 13 admissions with eight uroseptic episodes in those catheterised; with none in non-catheterised patients. The re-audit included 18 patients (6/18 catheterised) and the median wait for catheterised patients was 29 days.

Conclusion:
We were able to significantly reduce waiting time and morbidity for catheterised patients by prioritising them and setting a 30-day target. We are now working on improvements to the pathway for all patients.
A closed looped audit: Reducing catheter-related morbidity and improving TURP waiting times in line with GIRFT recommendations

Lam A1, Saaid S1, Wong K1, Nitkunan T1
1Epsom and St Helier University Hospitals NHS Trust, United Kingdom

Introduction:
In July 2018, Getting It Right First Time (GIRFT) recommended improved pathways for patients awaiting a TURP and in particular, the morbidity associated with catheterised patients. We reviewed a cohort of patients who underwent a TURP.

Methods:
All patients who underwent a TURP from 1 January 2018 to 31 December 2018 were included. Data was collected on waiting list times, whether a catheter was inserted, date of catheter insertion, Accident and Emergency (A&E) attendances for catheter-related issues and the number of admissions this resulted in. We made a change in our pathway to ensure that catheterised patients undergo a TURP within 30 days of waitlisting. We re-audited data from 1 November 2019 to 31 December 2019.

Results:
181 patients underwent a TURP in 2018; 65 were catheterised with 10/65 performing self-catheterisation. The median waiting list times for the catheterised patients and non-catheterised patients were near identical (118 v 119 days). 93/95 A&E attendances were in the catheterised cohort. The median number of A&E attendances was 1 (range 0-8), the first attendance 1-day post-catheterisation with the median being 20 days (range 1-618). There were 13 admissions with eight uroseptic episodes in those catheterised; with none in non-catheterised patients. The re-audit included 18 patients (6/18 catheterised) and the median wait for catheterised patients was 29 days.

Conclusion:
We were able to significantly reduce waiting time and morbidity for catheterised patients by prioritising them and setting a 30-day target. We are now working on improvements to the pathway for all patients.
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