Early findings of ward to clinic based TWOC model in post TURP patients. A possible effective model in COVID era

Buyungo, John Mohammed Kamil Quraishi Ewen Natasha Garnett Steve

Background and AimAnecdotal evidence reveals delayed discharges of post Transurethral resection of prostate(TURP) patients from the ward following a Trial without catheter(TWOC) due to lack of specialist decision making. The pilot study aimed at expediting discharges following TWOC by a specialist urology nurse SUN) involvement. The SUN would streamline the patient from the ward to the outpatient (OPD) recovery area, taking an early independent decision regarding failure of TWOC and subsequent discharge. This enables an improved turnover during the limited and stringent service availability during the peak and post COVID era.MethodsA dual design (retrospective and prospective) pilot study was performed. The length of inpatient stay following a TWOC for a TURP between June and August 2019 were analysed as current service practice. This was compared with a pilot scheme involving recruitment to a streamlined Post-TURP pathway that was implemented across 2 months in 2020.ResultsThirty eight patients were identified in the original service evaluation in 2019. The mean and median time patients waited prior to discharge with or without a catheter was 11.5 and 9 hours respectively. Six patients had an additional overnight stay due to late decision making on success of TWOC.Thirteen patients in the pilot scheme were recruited, transferred to the OPD recovery area had a mean and median stay of 6.5 and 7 hours respectively in the hospital after their catheter removal. A median number of 3.5 hours of inpatient bed stay was saved.ConclusionThe role of the SUN can improve resource allocation by freeing precious elective surgical beds. Additionally improves patient experience by shorter length of stay in hospital following a TWOC. We aim ensuring the same discharge path way to both post simple transurethral resection of bladder tumour and bladder neck patients takes place.