Clinical Practice

Look to SUNA for the latest in clinical practice guidelines, findings, and evidence-based research for the urologic nursing community.

SUNA joined the American Association for Homecare; United Spinal Association; Wound, Ostomy, and Continence Nurses Society; and Wound Ostomy and Continence Nursing Certification Board to develop a white paper to educate payers and state Medicaid programs on the types of intermittent catheter products and services needed to successfully manage an individual’s urinary retention needs in a home-based setting to improve patient experience, health outcomes, and reduce overall cost. Entitled The Critical Need to Provide Intermittent Catheter Urological Supplies Specific to Patient Need to Improve Health Outcomes, the white paper addresses the variables going into managing each person’s urinary retention needs, the role of the home medical equipment provider, the risks of improper management, the challenges of limited HCPCs codes for a variety of products, and the value of managing urinary needs with sustainable reimbursement.

Download the White Paper

SUNA and the American Urological Association (AUA) developed a joint Statement of Practice on Intravesical Administration of Therapeutic Medication for the Treatment of Bladder Cancer. The purpose of the statement is to define the performance guidelines surrounding the instillation of intravesical cytotoxic, immunotherapeutic, and/or therapeutic drugs via sterile technique catheterization for patients with non-muscle invasive bladder cancer (NMIBC, urothelial carcinoma).

Updated - 2020

Originally developed in July 2015, the paper was reviewed and revised in June 2020. 2020 Workgroup Members included Roxy Baumgartner, RN, APN-BC; Sam Chang, MD; Susan Flick, CNP; Howard Goldman, MD, FACS; Jim Kovarik, MS, PA-C; Yair Lotan, MD; Elspeth McDougall, MD, FRCSC, MHPE; Arthur Sagalowsky, MD; Edouard Trabulsi, MD; Debbie Hensley, RN; Christy Krieg, MSN, CUNP; and Leanne Schimke, MSN, CUNP

Download the Statement

SUNA collaborated with the American Urological Association on the development of three white papers on optimizing outcomes for patients before, during, and following urologic surgery:

Thank you to the following SUNA members who served as workgroup members or peer reviewers: Frances Foley, MHA, RN, CURN; Gwendolyn Hooper, PhD, APRN, CUNP; Michelle Lajiness, NP; Christopher Tucci, MS, RN, BC, CURN; Charlene Vollmer, BSN, RN-BC; and Glenda Wilkinson, BS, RN, CURN, CRLS, MLSO.

The Prostate Cancer Patient Guide is a comprehensive resource on diagnosis, treatment, side effects, and risk factors for patients and families with a history of prostate cancer. Developed by the Prostate Cancer Foundation, the guide is designed for any man newly diagnosed with or in treatment for prostate cancer, and for family members seeking information about prostate cancer patient navigation as well as their own short- and long-term risks factors for prostate cancer.

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The Flexible Cystoscopy: Training & Assessment Guideline and Flexible Cystoscopy: Performance Criteria, Training & Assessment Logbook have become the universal training package in using a flexible cystoscope. Created by our British colleagues, the British Association of Urological Nurses (BAUN) and the British Association of Urological Surgeons (BAUS), these free evidence-based guidelines are available for download on the BAUS website.

Go to these resources on BAUS website

SUNA supports nurse practitioners (NPs) performing office-based cystoscopy procedures (with training as outlined by Quallich et al. [2019]) as a vital way to address the need for access to quality urologic care. SUNA also acknowledges that in the past, NPs have been safely trained on-the-job to perform cystoscopy, but feels that moving forward, training can proceed with a more uniform, standardized approach.

Quallich et al. (2019) provide a template by which advanced providers can document education and training in order to expand their practice to include performing office cystoscopy. This template provides a guide for NPs in the United States to seek credentialing and privileging in order to move forward with offering cystoscopy as part of their clinical skills, and supports the Cystoscopy Workshop that SUNA offers at its national educational conferences.

Download the Position Statement

Download "Competencies for the Nurse Practitioner Working with Adult Urology Patients"


Reference
Quallich, S., Lajiness, S., Kovarik, J., Doran, T., Schultz, H., & Langston, J. (2019). Standardized office cystoscopy training for advanced practice providers in urology. Urology Practice, 10-1097.

Recognizing that nurse practitioners and physician assistants play a key role in team-based delivery of care, the American Urological Association has developed a Consensus Statement on Advanced Practice Providers. The Consensus Statement examines advanced practice provider integration from a regulatory and practice management approach. The Consensus Statement was developed by a workgroup featuring a diverse set of urologic providers, including physicians, nurse practitioners, and physician assistants. Susanne Quallich, ANP-BC, NP-C CUNP, FAANP, represented SUNA on the workgroup.

Go to the Consensus Statement

The European Association of Urology Nurses (EAUN) released a new Evidence-Based Guideline for Best Practice in Urological Healthcare at the 16th International EAUN Meeting in Madrid in March 2015. The guideline is entitled Intravesical Instillation with Mitomycin C or Bacillus Calmette-Guérin in Non-Muscle Invasive Bladder Cancer. Access the guideline at the link below.

Download the Guideline

The American Urological Association (AUA) has developed a White Paper on Catheter-Associated Urinary Tract Infections: Definitions and Significance in the Urologic Patient. A white paper workgroup organized by the Quality Improvement and Patient Safety Committee and led by Dr. Timothy Averch drafted the paper, which was approved by the AUA Board of Directors in October 2014. Diane K. Newman, DNP, FAAN, BCB-PMD, represented SUNA on the workgroup.

The workgroup noted that while health care in general has increased its focus on catheter-associated urinary tract infection (CAUTI) prevention and the inappropriate use of catheters, much of this attention does not apply to urologic patients. Therefore, the white paper delves in to this particular area and also provides pertinent definitions pertaining to CAUTIs.

Download the White Paper