Where are the Stents? A Computerized Tracking System to Eliminate the Forgotten Ureteral Stent. Issue 3 (May 2015) - Larkin, Spencer
Abstract : Introduction: : Ureteral stent placement is the main treatment for ureteral obstruction in contemporary urological practice. Meticulous followup is required to confirm ureteral stent removal. Forgotten ureteral stents create significant patient and physician risk. We assessed the efficacy of an electronic spreadsheet tracking system at a VA medical center urology practice to monitor ureteral stent placement and retrieval. Methods: : From January 2012 to February 2014 a computer based monitoring system was begun for all stents placed in our practice. An Excel® spreadsheet was used to track ureteral stent insertion and removal. The VA Computerized Patient Record System was used to confirm ureteral stent removal. The spreadsheet included an automatic calculator feature to alert technicians/surgeons when stents remained in place 180 days or longer. Results: : In 335 patients a total of 379 stents were placed from January 2012 to February 2014. Of these 379 stents 369 were removed or exchanged in 180 days or less. Ten patients died with stents in place and were counted in the removal group for an overall 100% rate of stents accounted for/removed during the study period. Conclusions: : An electronic spreadsheet is an effective method to track ureteral stent placement and removal. Manual data entry, and frequent spreadsheet followup and monitoring contributed to a 100% retrieval rate in this study. Future efforts should focus on automated systems that generate reminders with less emphasis on human data entry and tracking.