Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Australian sonographers' perceptions of patient safety in ultrasound imaging: Part two - translation into practice

Introduction

A lack of patient safety research hampers capacity to improve safety in healthcare.Ultrasound is often considered 'safe' as it does not use ionising radiation, a simplistic view of patient safety. Understanding sonographers' actions towards patient safety is crucial; however, self-reported measures cannot always predict behaviour. This study is part of a PhD exploring patient safety in medical diagnostic ultrasound. The aim of this paper is to explore sonographers' responses to the patient safety concerns identified in Part one of this study. The ultimate aim of the study is to inform the final phase of the doctoral study which will consider the next steps in improving the quality and safety of healthcare experienced by patients.

Methods

A qualitative study using semi-structured, one-on-one interviews. The Theory of Planned Behaviour (TPB) explained how sonographers respond to perceived patient safety risks in practice.

Results

Thirty-one sonographers were interviewed. Based on the seven themes identified in Part one of the study, results showed that incongruences exist between identifying patient safety risks and the actions taken in practice to manage these risks.

Conclusion

The TPB showed that behavioural, normative and control beliefs impact sonographers' responses to perceived patient safety risks in practice and can lead to risk avoidance. Lack of regulation in ultrasound creates a challenge in dealing with Fitness to Practice issues. Collective actions are required to support sonographers in taking appropriate actions to enhance patient safety from multiple stakeholders including accreditation bodies, regulatory authorities, educational institutions and employers.

UK obstetric sonographers' experiences of the COVID-19 pandemic: Burnout, role satisfaction and impact on clinical practice

Introduction

The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice.

Methods

An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress.

Results

Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years.

Conclusion

Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic.

Do Practice Policies Limit Distractions and Improve the Quality During an Obstetric Sonogram?

Objective:

To assess if distractions alter sonographers’ perceptions of an obstetric sonogram’s (OBS) quality and whether clinic policies mitigate this association.

Materials and Methods:

Members of the Society of Diagnostic Medical Sonography were surveyed regarding demographics, perceived distractions during OBS, clinic observer and/or recording policies, plus perceptions of OBS quality concerns. Distraction and OBS quality scores were calculated. Chi-squared tests were used for bivariate analysis. Logistic regression identified independent predictors of OBS quality concerns.

Results:

There were 805 surveys completed. Many respondents (68%) found more than 75% of behaviors distracting, which was associated with increased reports of OBS quality concerns (adjusted odds ratio [aOR] = 3.63, 95% confidence interval [CI]: 2.55, 5.15), despite respondents’ demographics or clinic policies. More distracting behaviors (79%, P < .01) and quality concerns (40%, P = .04) were noted by sonographers who wanted, but did not have, recording policies at their clinic. Increased quality concerns correlated with disagreement concerning current recording policies (aOR = 2.89, 95% CI: 1.11, 8.00) and desired but absent observer policy (aOR = 2.24, 95% CI: 1.09, 4.59), regardless of respondent demographics or distraction score.

Conclusion:

Increased distraction scores are associated with more sonographer reports of OBS quality concerns. The lack of desired policies was associated with increased distractions and quality concerns. Further work is needed to understand the relationship between clinic policies, perceived distraction, and OBS quality.

Concentrating in a Loud Crowd: Sonographer Perceptions of Policies to Limit Distractions in Obstetric Sonography Examinations

Objective

The objective was to identify sonographer perceptions of distractions and policies for improving obstetric sonography examinations (OBUS).

Materials and Methods

A survey, with closed- and open-ended questions, was sent to OBUS practicing members of the Society of Diagnostic Medical Sonography (SDMS). Descriptive analyses, including frequency distributions overall and by various groups, were performed. Chi-square analyses were used to examine the relationships between categorical variables, including level of perceived distraction, and concordance with policies.

Results

Of the 3525 accessed e-mails, 807 responses were eligible for analysis. Over half (62%) of the respondents reported no observer policy. Sonographers reported strong agreement with observer policies and desired limits on observers. Policy disagreement themes included number of observers, children observers, patient satisfaction, and patient truthfulness. Most sonographers reported existence of (85%) and strong agreement (97%) with recording policies. Disagreements centered around the strictness of policies, policy enforcement and notification, distraction of recording, medico-legal issues, and finding anomalies while being recorded.

Conclusion

Discrepancies existed between policies regarding observers and recording in OBUS. Sonographers both desired and agreed with protocols to limit distractions. However, there were concerns regarding stringency, notification, and enforcement of policies. Further research is needed to determine if policies help limit distractions during OBUS.