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

Area of Science:

• Interventional Radiology
• Nephrostomy Catheter Management
• Healthcare Service Delivery

Background:

• Nephrostomy tubes require regular exchanges to maintain patency.
• Traditional nephrostomy exchange services are often managed by radiologists, potentially straining departmental capacity.
• Exploring alternative models for service delivery is crucial for efficient patient care.

Purpose of the Study:

• To evaluate the technical success, radiation dose, complications, and costs associated with a radiographer-led nephrostomy exchange service.
• To compare radiographer performance against established radiologist benchmarks.

Main Methods:

• Post-graduate qualified interventional radiographers performed nephrostomy exchanges after specific training and supervised practice.
• Radiographers managed radiological reporting, patient discharge, and follow-up, including urine cultures.
• Data collected included procedure success, radiation dose, fluoroscopy time, complication rates, and time intervals between exchanges.

Main Results:

• 170 nephrostomy exchanges were performed on 38 long-term patients.
• No statistically significant differences were found in radiation dose, fluoroscopy time, or complication rates between radiographers and consultant radiologists.
• A statistically significant reduction in the time interval between nephrostomy exchanges was observed in the radiographer-led group (P=0.022).

Conclusions:

• Interventional radiographers can safely and effectively perform nephrostomy exchanges, achieving radiation doses comparable to radiologists.
• This radiographer-led service is a cost-effective solution addressing capacity issues in interventional radiology departments.
• Implementing such services can enhance career progression for radiographers and potentially improve patient care.