A nurse led cauda equina service: a quality improvement project

Abstract

Background: People with cauda equina syndrome (CES) often experience bladder, bowel and sexual dysfunction, which can result in short to significant issues. It was recognised in the authors' hospital that the post-operative follow-up and management of CES complications was inconsistent for CES patients. Consequently, a nurse led cauda equina service was developed using a quality improvement framework that focused on enhancing the post-operative care and the support these patients receive both in hospital and following discharge. Aim: To evaluate this 2-year long nurse led CES service to identify areas of success and improvement. Results: In this particular hospital, there was a yearly increase in CES patients (46 patients in 2020 and 59 patients in 2021), with many patients left with some degree of bladder (26%), bowel (30%) and sexual (24%) dysfunction. Conclusion: It is clear that the nurse led cauda equina service has improved the process for managing patients with CES post-surgery.