Active involvement of nursing staff in reporting and grading complication‐intervention events—Protocol and results of the CAMUS Pilot Nurse Delphi Study

Abstract

Objectives: The aim of this study is to gain experienced nursing perspective on current and future complication reporting and grading in Urology, establish the CAMUS CCI and quality control the use of the Clavien-Dindo Classification (CDC) in nursing staff. Subjects and Methods:The 12-part REDCap-based Delphi survey was developed in conjunction with expert nurse, urologist and methodologist input. Certified local and international inpatient and outpatient nurses specialised in urology, perioperative nurses and urology-specific advanced practice nurses/nurse practitioners will be included. A minimum sample size of 250 participants is targeted. The survey assesses participant demographics, nursing experience and opinion on complication reporting and the proposed CAMUS reporting recommendations; grading of intervention events using the existing CDC and the proposed CAMUS Classification; and rating various clinical scenarios. Consensus will be defined as ≥75% agreement. If consensus is not reached, subsequent Delphi rounds will be performed under Steering Committee guidance.Results: Twenty participants completed the pilot survey. Median survey completion time was 58 min . The survey revealed that 85% of nursing participants believe nurses should be involved in future complication reporting and grading but currently have poor confidence and inadequate relevant background education.Overall, 100% of participants recognise the universal demand for reporting consensus and 75% hold a preference towards the CAMUS System. Limitations include variability in nursing experience, complexity of supplemental grades and survey duration.

A Prospective Multi-institutional Study Using a Novel Safety Valve for the Prevention of Catheter Balloon Inflation Injury of the Urethra

“…The CAMUS (Complications After Major and Minor Urological Surgery) Collaboration has been proposed as a method of complication reporting to improve surgical care and could be utilized by both nursing and medical staff. [15][16][17] The initial Foley catheter was designed in the 1930s and has undergone minimal modifications since. 18 Although Tiemann or Coud e tipped catheters can help to navigate an enlarged prostate, use of such catheters may risk exacerbating CBI if the urethral wall has been injured or frankly ruptured by (even partial) balloon inflation.…”

“…The CAMUS (Complications After Major and Minor Urological Surgery) Collaboration has been proposed as a method of complication reporting to improve surgical care and could be utilized by both nursing and medical staff. 15-17…”

Evolution and Implications of the Novel CAMUS Reporting and Classification System: From Rationale to End Product

“…The CAMUS reporting and classification system was proposed to fill this void for recording and holistic assessment of a patient’s entire operative and postoperative morbidity within a single system [1] . Concurrent Delphi studies assessing the opinions of urologist, critical care specialist, and nursing groups [2] are under way and will provide valuable insight from chief stakeholders. We propose a classification system with a main CAMUS grade, four supplementary grades, and a CAMUS comprehensive complication index (CCI) based on worldwide expert opinion [3] .…”