Journal of Surgical Simulation 2021; 8: A: 4 - 4
Published: 30 June 2021
Special Issue: Audit of immediate instillation of intravesical chemotherapy (mitomycin-C) following transurethral resection for bladder tumour
Aims: The administration of immediate instillation of intravesical chemotherapy (IVCT) following transurethral resection of bladder tumour (TURBT) has been shown to decrease the risk of recurrence and is recommended as standard practice following TURBT for new and recurrent tumours. Our aim was to evaluate the adherence to this guideline in our trust and if needed, to implement changes in order to improve the patient care.
Methods: A retrospective analysis of 25 patients was done and details regarding the time interval between administration, demographic details and disease staging were collected. NICE guidelines were later implemented and the data was re-collected for 24 patients who underwent TURBT.
Results: The analysis showed that the mean time between the end point of TURBT and instillation of intravesicular mitomycin-C was 7.66 h. Thereafter, we tried to implement the guidelines by improving communication between the theatre staff, nursing staff and the pharmacy. The data were collected for re-audit for 24 patients and it was observed that the interval between surgery and mitomycin administration had dropped down to 4.67 h. The 3rd cycle of the audit revealed the interval dropping down further to 4.24 h. The 24 h administration rate was >90%, which was much higher than previous year audits.
Conclusion: Engagement with theatre team and pharmacy is required, in order to coordinate the delivery of the IVCT to theatre for administration at the time of surgery. If everyone (hospital pharmacy and theatre staff) is supportive, patients’ quality of care can be improved by following the standardised protocol.
transurethral resection of bladder tumour; intravesical chemotherapy; audit; mitomycin-C
This presentation was given at the SES 2020 online conference, 4 July 2020.