P05_Nonresearch_CE - Nursing Considerations and Patient Safety of Transperineal Prostate Biopsy in a Urology Clinic

Significance and background: Prostate biopsy is the gold standard to diagnose prostate cancer and is typically performed in the outpatient setting. Nurses heavily support this procedure by managing procedure set-up, assisting during the procedure, and providing emotional support and education to the patient. Due to the nature of the transrectal approach, sepsis is a common complication, with a reported rate of 1-17.5%. Transperineal prostate biopsy (TPPB) has been successfully transitioned to the outpatient setting, more commonly performed in Europe. In the United States, this approach is usually performed in the OR.

Purpose: This procedure was recently implemented in a high-volume outpatient urology clinic, which performs approximately 50 prostate biopsies a month. This abstract will share the logistics and nursing implications on transitioning this procedure into an outpatient setting.

Interventions: An interdisciplinary team explored the safety and feasibility of implementing the TPPB procedure to high risk patients. Literature was reviewed to understand the safety, procedural steps, and clinical considerations of converting this procedure from the operating room to the outpatient setting. In-services were developed to help educate nursing staff.

Evaluation: A high-risk immunocompromised patient was selected to pilot this procedure in the urology clinic. The patient underwent the biopsy without difficulty and showed no signs of sepsis post procedure. The patient’s experience was comparable to the typical transrectal approach, although pain management was noted to be an opportunity for improvement. Several more patients have been scheduled and outcomes will be reported at a later date.

Discussion: The implications for urology nurses include need for education related to equipment, procedure set-up, and support for physician and patient. Nurses are pivotal in supporting patients through this procedure due to its significance in accurately diagnosing cancer. The experience from this clinic can be shared with other urology clinics considering adopting this procedure.