Establishing a national goal-directed nursing course on managing intravesical instillation

Introduction &amp; Objectives<br/>Specialized nurses perform intravesical instillation therapy, requiring extensive skills in disease management, safety, and handling adverse events. However, there is an increasing turnover of specialized nurses in the urological departments. Continuous education in intravesical instillation can improve service quality, safety, and patient experience in treating non-muscle invasive bladder cancer (NMIBC). Currently, there is no standardized education or certification program. A Danish group of nurses aimed to develop an evidence-based course to enhance nursing skills and capacity in intravesical therapy to bridge this gap. The purpose was to develop a dynamic, evidence-based, advanced educational course to enhance the quality of care, increase adherence to guidelines, and improve nurse confidence in performing intravesical instillations. Secondly, it aimed to increase the capacity of nurses to perform intravesical procedures across the country.<br/><br/>Materials &amp; Methods<br/>A national steering group was established across all regions in Denmark. In each region, the corresponding university hospital was represented by supporting both academic and clinical nurse competencies. The steering group had four meetings during 2023 to define the framework, learning outcomes, content, and course design. The content followed the recommendations from the EAUN guidelines on intravesical instillations. All head nurses in the Urological departments were approached to adjust mutual expectations and secure anchored-based leadership and ethical alignment.<br/><br/>Results<br/>A two-day course was held to reflect any step in performing intravesical therapy involving the patient perspective and the multi-professional team involved in the treatment of NMIBC. The course included lectures on anatomy, NMIBC, cystitis, introduction to EAUN guidelines, hands-on training, and experience sharing local guidelines and documentation. The first course was held in February 2024, and 20 Danish urological nurses attended. Participants were satisfied with the theoretical content and the practice-sharing possibilities. The course will be further evaluated from the patient and nurses’ perspectives, and results will be used to improve future national courses.<br/><br/>Conclusions<br/>This is the first theoretical and hands-on course improving the quality of care for intravesical therapy in patients with NMIBC. We expect the course to enhance the competence among urological nurses in intravesical instillation therapy. Furthermore, a thorough evaluation of the course will provide valuable information and enable the education group to adjust content to EAU /EAUN's current guidelines. In future courses, patients will be invited to plan the courses and participate in the steering group. We aim to make it a yearly course, with the potential to expand and include other urological procedures. Finally, we will include nurses from primary care to bring the hospital to the patient.