Winner
Developing and Centralising a Nurse Led Transperineal Biopsy Service Under Local Anaesthetic
Summary of work
Biopsy remains an integral part in confirming a diagnosis of prostate cancer. Transrectal ultrasound (TRUS) guided biopsies are typically more widely used to easy access to equipment and the fast nature of the procedure. Typically, transperineal (TP) biopsies were used as a second line investigation due to the requirement for general anaesthesia (GA), specialised equipment and training. In Europe and America TRUS is still more widely used.
TP biopsies are considered safer with studies showing less post-biopsy related sepsis, furthermore areas of the prostate that are inaccessible to TRUS biopsy are better sampled by the TP approach. Prior to COVID-19, prostate cancer diagnostics were performed across four sites in Barts Health NHS Trust using the TRUS approach. TP biopsies took place as a second line investigation under GA by a consultant urologist. During the pandemic, we ceased the TRUS biopsy service and utilised a specialist urology nurse to start performing TP biopsy at a single site under local anaesthetic. By using run charts we were able to monitor the service in real-time ensuring there were no delays to the patient’s procedure. By transforming our service we have not only freed up valuable resources, but improved patients’ experience and outcomes.
Judges’ comments
Whipps Cross and Newham University Hospital’s entry was an absolute masterclass in adhering to a brief. They demonstrated excellence in strategy, measurables and execution. Clearly had a huge impact and really addressed the culture and aims. It was incredibly well put together and a breath of fresh air!
