Development and evaluation of a centralised computerised registry for ureteric stents: completing the audit cycle

Ir J Med Sci. 2017 Nov;186(4):1057-1060. doi: 10.1007/s11845-016-1534-3. Epub 2017 Feb 2.

Abstract

Introduction: A forgotten ureteric stent may result in severe renal impairment leading to nephrectomy.

Aim: To compare the effectiveness of a centralised computerised registry for monitoring ureteric stent activity with a previously established theatre stent logbook system.

Methods: This prospective audit was performed in two 9-monthly intervals. During the first interval, insertion/removal of a ureteric stent was documented in a specific theatre stent logbook. In the second interval, an electronic centralised computerised registry was developed to document insertion/removal of a ureteric stent onto an accessible hospital server. A computerised traffic-light system was also developed to identify patients with an indwelling stent for >3 months. The primary outcome variable was the number of prolonged indwelling ureteric stents in both groups.

Results: During the first time interval, 188 ureteric stents were inserted and 182 (96%) were removed or changed. Six (4%) patients underwent insertion of a ureteric stent for a prolonged period of time (>6 months). This subgroup required complex endourological intervention for stent removal due to encrustation. During the second time interval, 157 ureteric stents were inserted and all patients had their stent removed or changed within 6 months. No patients in this group were lost to follow-up.

Conclusion: This study demonstrates that a centralised computerised ureteric stent registry is superior to a conventional logbook for monitoring ureteric stent activity. We propose the introduction a centralised nationalised ureteric stent registry for eliminating the potential for prolonged or forgotten ureteric stents.

Keywords: Audit cycle; Centralised database; Forgotten stent; JJ stent; Ureteric stent.

MeSH terms

  • Computers / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Prospective Studies
  • Registries
  • Stents / adverse effects*
  • Ureter / surgery*