Initial single centre experiences of a radiographer advanced practitioner led nephrostomy exchange programme |
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| Affiliation: | 1. Department of Radiology, Manchester Royal Infirmary, Manchester, UK;2. University of Salford, Salford, UK;1. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;2. Orthopedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;3. Biomechanics and Imaging Group (BIG), Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands;4. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;1. College of Applied Medical Sciences, Taibah University, Medina, 42353, Saudi Arabia;2. School of Health and Society, University of Salford, Salford, M5 4WT, United Kingdom;3. Oslo Metropolitan University, Faculty of Health Sciences, Norway;4. Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Radiumhospitalet, Oslo, Norway;1. Diagnostic Radiology Department, American University of Beirut Medical Center, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon;2. American University of Beirut, P.O. Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon;1. Medical and Clinical Sciences Research Hub, School of Allied & Public Health Professions, Canterbury Christ Church University, Kent, ME4 4UF, UK;2. The Association of British Dispensing Opticians College, Godmersham Park, Godmersham, Canterbury, Kent, CT4 7DT, UK |
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| Abstract: | IntroductionTo evaluate the technical success, radiation dose, complications and costs from the introduction of a radiographer-led nephrostomy exchange service.MethodsPost-graduate qualified interventional radiographers with several years' experience in performing other interventional procedures began performing nephrostomy exchanges. Training was provided by an interventional radiologist. Each radiographer performed ten procedures under direct supervision followed by independent practice with remote supervision. Each radiographer was then responsible for the radiological report, discharge, re-referral for further exchange and, where indicated, sending urine samples for culture and sensitivity. Data extraction included the time interval between exchanges, radiation dose/screening time and complications.ResultsThirty-eight long-term nephrostomy patients had their histories interrogated back to the time of the initial insertion. The mean (range) age at nephrostomy insertion was 67 (35–93) years and 65% were male. Indications for nephrostomy were prostatic or gynaecological malignancy, ureteric injury, bulky lymphoma and post-transplant ureteric stricture. A total of 170 nephrostomy exchanges were performed with no statistically significant differences in the radiation dose, fluoroscopy time nor complication rates between consultants and radiographers. There was, however, a statistically significant reduction in the time interval between nephrostomy exchanges for the radiographer group (P = 0.022).ConclusionInterventional radiographers can provide a safe, technically successful nephrostomy exchange program with radiation doses equivalent to radiologists. This is a cost-effective solution to the capacity issues faced in many departments, whilst providing career progression, job satisfaction and possibly improved care.Implications for practiceRadiographer-led interventional services should be considered by other institutions as a means of providing effective nephrostomy exchanges. |
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| Keywords: | Advanced practice Nephrostomy Interventional radiology |
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