Hypothesis / aims of study
Ultrasound is a key component in the assessment of lower urinary tract function and in guiding urological procedures. Increasing service demand, workforce constraints, and the need for rapid clinical decision-making have driven interest in task-sharing models involving trained nursing professionals.
While nurse-led ultrasound has been adopted in other clinical settings, its structured implementation in urology remains limited and variably defined.
This study aimed to evaluate the feasibility, safety, clinical utility, and system-level impact of implementing nurse-performed focused urological ultrasound within routine clinical pathways.
Study design, materials and methods
A structured service evaluation supported by a narrative evidence synthesis was conducted in a tertiary urology department. A competency-based implementation framework was developed to support the introduction of nurse-performed focused urological ultrasound.
Clinical applications included measurement of post-void residual (PVR), focused bladder assessment, catheter balloon verification, and procedural support in selected interventions.
Training incorporated theoretical modules covering urinary tract anatomy and ultrasound principles, followed by supervised hands-on practice. Competency was achieved through structured assessment and sign-off, ensuring standardisation and safety.
Outcomes of interest included feasibility of implementation, diagnostic reliability in routine clinical use, safety profile, and impact on workflow efficiency, clinical decision-making, and patient pathways.
Results
Nurse-performed focused urological ultrasound was successfully integrated into routine clinical practice and demonstrated high clinical utility across multiple care settings.
Ultrasound assessments provided reliable evaluation of post-void residual volume and catheter position, enabling immediate bedside clinical decision-making. No ultrasound-related complications or safety concerns were identified during implementation.
The introduction of nurse-performed ultrasound reduced reliance on physician-performed imaging and facilitated earlier patient assessment and intervention. It enabled more efficient use of medical time while maintaining diagnostic accuracy.
Nurses contributed directly to diagnostic pathways and procedural workflows, including support during suprapubic catheterisation and optimisation of catheter-related management.
Overall, the model improved multidisciplinary communication, reduced delays in assessment, and streamlined patient flow within the service.
Interpretation of results
These findings demonstrate that nurse-performed focused urological ultrasound is not only feasible and safe but represents a clinically meaningful expansion of nursing scope within urological care.
By enabling timely bedside assessment and reducing dependency on physician-led imaging, this model improves diagnostic efficiency and accelerates clinical pathways. The benefits observed extend beyond individual tasks, reflecting a shift towards integrated, multidisciplinary care delivery.
Importantly, the use of a competency-based training framework ensures reproducibility and supports safe implementation across different clinical settings.
Concluding message
Nurse-performed focused urological ultrasound is a safe, feasible, and clinically effective strategy to optimise diagnostic pathways and service delivery in urology.
Its implementation enables earlier clinical decision-making, enhances procedural safety, and improves workflow efficiency through multidisciplinary integration.
This model represents a scalable, sustainable, and transferable approach that can support modern urological services facing increasing demand and resource constraints.