Targets not only drive forward service change but influence change in practice

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The aim of this article is to illustrate and discuss how a change in service delivery and nursing role influenced the need for further changes in the interventions between the urology unit and the patient. This highlighted the fact that there were varying styles and means of disseminating results and especially when informing patients of what could be potentially confusing biopsy results such as those which have revealed high-grade prostatic intraepithelial neoplasia. Some practices could lead to the patients being confused or worried, as they have not been afforded pure choice according to their individual wishes. After reviewing the literature, and explaining the histological diagnosis that is high-grade intraepithelial prostatic neoplasia, an information leaflet has been developed that can be given to patients receiving such results, thus ensuring patients are all given standard written information minimizing inter-clinician variations. The changing role of the clinical nurse specialist within the urological team will be discussed, as well as the service delivery changes that took place within that team which led to the need to challenge existing practices that have continued throughout the years.

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