The Royal College of Radiologists (RCR) and the British Society of Interventional Radiology (BSIR) have called for a UK-wide clinical registry for ureteric stents, following the release of a report investigating delayed removal of the devices.
The Healthcare Safety Investigation Branch (HSIB) released a report on 22 October titled, “Unplanned delayed removal of ureteric stents”, highlighting the need for better clinical communication and monitoring standards around ureteric stent use.
The new HSIB report was instigated following a reference case involving a patient who was fitted with a stent following surgery for kidney stones. Removal of the stent was delayed, and the device became encrusted, causing ongoing urinary infections before it was eventually removed.
England-wide themes considered by HSIB include the different processes used for stent logging and tracking, varying communications between hospital teams and GPs, and the need for standardised advice for patients.
HSIB recommends the creation of national standards to support paper and electronic logging systems, enhanced patient information and guidance for clinicians, and for stent status and further information to be included on all hospital discharge letters and other communications sent to GPs.
The RCR and BSIR welcome the report and agree with its findings, but also argue that stent monitoring could be further centralised and given clear clinical incentives.
Ian McCafferty, BSIR president and member of the RCR’s Interventional Radiology Committee, says: “Interventional radiology (IR) plays a significant role in stent insertion and removal across specialties, including ureteric stenting. Radiology workload is also only increasing here, particularly as ‘COVID-secure’ IR services have picked up more cases during the pandemic. As a result, IR consultants and their teams are implicated in ensuring these devices are flagged and tracked.
“The RCR and BSIR fully agree stents should be removed at replaced at appropriate timescales, with a robust tracing system for their use.
“HSIB recommends more professional standards to support ureteric stent monitoring. However, ideally we believe there needs to be an open-access, UK-wide stent registry. In addition, tariff reimbursement should be linked to registration, to ensure all devices are properly registered and therefore monitored.
“Providers would also need to appoint leads to support clinicians logging the devices and to ensure local data is kept up-to-date.”