What influences adherence to guidance for postoperative instillation of intravesical chemotherapy to patients with bladder cancer?
Jennifer DunsmoreEilidh DuncanParamananthan MariappanMarijn de BruinSara MacLennanKonstantinos DimitropoulosVeeru KasivisvanathanHugh MostafidAlberto BrigantiJames N'DowSteven MaclennanPublished in: BJU international (2021)
High-certainty evidence shows that SI-IVC, such as MMC, after NMIBC resection reduces recurrences. This evidence underpins international guidance. The number of eligible patients receiving SI-IVC is variable indicating suboptimal practice. Improving SI-IVC adherence requires modifications to theatre instilling policies, delivery and storage of MMC, staff training, and documentation. Centralising care, with bladder cancer expert leadership and best practices sharing with performance targets, likely led to improvements in Scotland. National quality improvement, incorporating audit and feedback, with additional implementation strategies targeted to professional role could improve adherence and patient outcomes elsewhere. This process should be controlled to clarify implementation intervention effectiveness.
Keyphrases
- quality improvement
- inferior vena cava
- patient safety
- muscle invasive bladder cancer
- healthcare
- primary care
- randomized controlled trial
- room temperature
- public health
- systematic review
- patients undergoing
- glycemic control
- type diabetes
- pulmonary embolism
- social media
- squamous cell carcinoma
- locally advanced
- cancer therapy
- electronic health record
- drug delivery
- clinical practice
- rectal cancer
- palliative care
- pain management
- radiation therapy
- chronic pain
- health information
- ionic liquid