Abstract
Background: Bladder cancer is one of the most common cancers worldwide. The recurrence rate and disease progression is high, therefore cystoscopy is vital in its diagnosis and surveillance. Due to the increased demand for cystoscopy and challenges in meeting the need for performing the procedure, advanced nursing roles have been developed and nurse-led clinics performing cystoscopy started. Nurses performing flexible cystoscopy have the potential to improve access to healthcare and patient satisfaction while delivering equivalent services to patient.
Aim: The aim of this review was to examine the published evidence on clinician and patient experiences and patient outcomes in nurse-led flexible cystoscopy in the outpatient clinic for bladder cancer diagnosis and surveillance. The issues of focus in this review are the patients and nurses' experiences as well as patient outcomes from the nurse-performed cystoscopy.
Methods: An integrative literature review as described by Whittemore and Knafl (2005) was used in this study. CINAHL, Medline, Google Scholar and EMBASE databases were searched for published literature between 2011 to 2023 that meet the eligibility criteria. Critical appraisal was done using matched JBI quality appraisal checklist and data analysis was conducted using the constant comparison method as described by Whittemore and Knafl (2005).
Findings: A total of 12 articles were reviewed and four syntheses were identified. 1. There is a high level of patient satisfaction on nurse performed flexible cystoscopy. 2. Nurse-led flexible cystoscopy clinics improved patient access to diagnostic and surveillance cystoscopy. 3. Patients had similar outcomes in doctor and nurse performed cystoscopy. 4. Adequate nurse education, training and supervision was essential in setting-up a nurse-led cystoscopy clinic.
Conclusion: Nurse-led flexible cystoscopy was well received by patients and enhanced access to bladder cancer diagnostic and surveillance healthcare services while maintaining the quality of care. A focused and efficient education, training and clinical supervision for the nurses is important to achieve these outcomes. Further research is needed to strengthen the evidence supporting the potential of nurse-led cystoscopy in reshaping the delivery of healthcare.