Initial single centre experiences of a radiographer advanced practitioner led nephrostomy exchange programme

Hoddes, R; Hattab, A; England, A

Abstract

PURPOSE: To evaluate the technical success, radiation dose, complications and costs from the introduction of a radiographer-led nephrostomy exchange service.
METHODS: Post-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.
RESULTS: Thirty-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 differences in the radiation dose, fluoroscopy time nor complication rates between consultants and radiographers. There was, however, a statistical reduction in the time interval between nephrostomy exchanges for the radiographer group (P=0.022).
CONCLUSION: Interventional 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 PRACTICE: Radiographer-led interventional services should be considered by other institutions as a means of providing effective nephrostomy exchanges.

• Journal Article Type: Article
• Acceptance Date: Nov 10, 2019
• Online Publication Date: Dec 10, 2019
• Publication Date: May 1, 2020
• Deposit Date: Oct 3, 2019
• Publicly Available Date: Dec 10, 2020
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Volume: 26
• Issue: 2
• Pages: 163-166
• DOI: https://doi.org/10.1016/j.radi.2019.11.091
• Publisher URL: https://doi.org/10.1016/j.radi.2019.11.091
• Related Public URLs: https://www.sciencedirect.com/journal/radiography
• Additional Information: Additional Information : Initially titled "Single centre radiographer advanced practitioner led nephrostomy exchange programme : 3 year experience."