The introduction of a Nurse-Led Urology Clinic at Roscommon University Hospital for Lower Urinary Tract Symptoms (LUTS) has significantly enhanced patient care and reduced waiting times, while also reducing the number of patients who require consultant urologist review. 

The clinic was established to provide a focused, targeted, urological assessment of symptoms, as well as treatment and support. It also provides education to enable patients to manage their urological condition without surgery and aims to reduce waiting times for LUTS assessment and management. 

Prior to the commencement of the Advanced Nurse Practitioner (ANP) LUTS clinic in February, patients who required ongoing nursing management or intervention were referred to University Hospital Galway. Since the introduction of the clinic, waiting times from referral to review have decreased from 1 to 2 years to 6 to 8 weeks at present, with 156 new patients assessed between February and June. 

LUTS, and specifically male LUTS, is one of the most prevalent complaints presenting to the Urology Outpatients Department. Research conducted by the HSE National Clinical Programme in Surgery (NCPS) revealed that male LUTS is one of the more common causes for referral to a urologist in the Saolta University Health Care Group.

Professor Eamonn Rogers, Consultant Urologist at Saolta University Health Care Group and Co-Lead National Clinical Programme in Surgery, explained that “the Nurse-Led Urology Clinic is one of the strategies of the Model of Care in Urology developed by the NCPS to improve access for urological care and to reduce waiting times to be seen in clinics.”

Michelle Healy, Advanced Nurse Practitioner and Clinic Lead, outlined how they have an “excellent urology service here at Roscommon University Hospital, between the Rapid Access Haematuria service and the LUTS service, and to have two visiting Consultant Urologists from University Hospital Galway aligned to the service and supporting us, is fantastic.

“We are providing care to patients as close to home as possible. Our patients always comment on how easy it is to travel to Roscommon, and how tremendous the service is. So it's wonderful to see that the clinic is already making a significant difference in the lives of our patients. As ANP, my role involves the evaluation of urinary flow rates, catheterisation, teaching and education on intermittent self-catheterisation and self-intermittent dilatation, benign bladder instillations and endoscopic guidance of guidewire to facilitate catheterization."

"This clinic is the first step towards a more comprehensive approach to LUTS care. It will ensure that patients are assessed and treated in a timely manner, and that patient outcomes improve while hospital admissions are reduced. It means we can free up consultants to see patients with more complex urological conditions.”

The referral pathway to the clinic for patients experiencing LUTS is via their GP to the consultant urologist who triages the referral to the ANP-LUTS clinic. Patients with any red flags, such as haematuria, are referred to the consultant urologist for further investigation. 

A native of Ratoath in County Meath, Michelle obtained her general nursing degree from Dundalk Institute of Technology in 2011 and began her career as a staff nurse at Our Lady of Lourdes Hospital in Drogheda. While there she worked across various departments, including medical, surgical and ICU (Intensive Care Unit). Her interest in urology began when she relocated to Roscommon University Hospital in 2015 and started working as a theatre nurse.

In 2019 after completing a postgraduate certificate in Applied Health studies in Urology at the University of Ulster, Michelle went on to take up the role of candidate Advanced Nurse Practitioner in Lower Urinary Tract Symptoms (LUTS) at Roscommon University Hospital. 

In November 2023 after graduating with an Honours Master’s Degree in Advanced Nursing Practice from the University of Galway, Michelle entered the nursing register as an Advanced Nurse Practitioner.

Advanced Nurse Practitioners are the highest level of clinical experts in the nursing profession in Ireland today. They are transforming services for patients through an expanded scope of practice, greater clinical autonomy and decision-making.

Marie Doorly, Interim Hospital Manager explained how the introduction of the ANP-led LUTS clinic has “significantly improved waiting times for patients referred to Roscommon University Hospital. It has reduced the number of patients requiring consultant urologist review, representing a quality improvement in service provision and a significant step towards integrated management and care delivery.”