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Kubo E, Nagata M, Yoshinaga N. The use of ultrasonography in education for undergraduate nursing students: A literature review. Jpn J Nurs Sci 2024; 21:e12596. [PMID: 38527918 DOI: 10.1111/jjns.12596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/27/2024]
Abstract
AIM The incorporation of ultrasonography into nursing practice is becoming more common, but how ultrasonography is used or applied in nursing student education is still unclear. This study aimed to review and synthesize relevant literature on the use of ultrasonography in education for undergraduate nursing students. METHODS An electronic literature search was conducted in June 2022 (updated in June 2023) using MEDLINE, CINAHL, Scopus, and Ichushi-Web databases. Two researchers independently screened/assessed the eligibility of the studies, synthesized extracted data using a narrative synthesis (due to anticipated heterogeneity across studies), and evaluated the methodological quality of quantitative studies using the Medical Education Research Study Quality Instrument. RESULTS Thirteen peer-reviewed articles were included in the review. All of the studies were conducted in high-income countries, and the majority of them employed an uncontrolled single-group design. Ultrasonography was used mainly for visualizing the vascular system to improve students' puncture skills, but it was also used with various other applications. The included studies were predominantly of moderate quality and heterogeneous, but all of them reported at least some benefits in nursing student education, such as enhancing knowledge and understanding of subcutaneous anatomical structures, and improving confidence in and/or skills of venipuncture and other visualization/assessment methods. CONCLUSIONS This review provides a broad perspective and highlights the potential use of ultrasonography in education for undergraduate nursing students. Further research is needed to develop standardized teaching methods/curriculum and competency assessments in order to ensure minimum competency standards for students and to improve clinical outcomes for patients.
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Affiliation(s)
- Eri Kubo
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Miu Nagata
- Department of Nursing, University of Miyazaki Hospital, Miyazaki, Japan
- Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Naoki Yoshinaga
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Dupriez F, Niset A, Couvreur C, Marissiaux L, Gendebien F, Peyskens L, Germeau B, Fasseaux A, Rodrigues de Castro B, Penaloza A, Vanpee D, Bobbia X. Evaluation of point-of-care ultrasound use in the diagnostic approach for right upper quadrant abdominal pain management in the emergency department: a prospective study. Intern Emerg Med 2024; 19:803-811. [PMID: 38041765 DOI: 10.1007/s11739-023-03480-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 11/04/2023] [Indexed: 12/03/2023]
Abstract
Point-of-care ultrasound (PoCUS) is commonly used at the bedside in the emergency department (ED) as part of clinical examinations. Studies frequently investigate PoCUS diagnostic accuracy, although its contribution to the overall diagnostic approach is less often evaluated. The primary objective of this prospective, multicenter, cohort study was to assess the contribution of PoCUS to the overall diagnostic approach of patients with right upper quadrant abdominal pain. Two independent members of an adjudication committee, who were blind to the intervention, independently evaluated the diagnostic approaches before and after PoCUS for the same patient. The study included 62 patients admitted to the ED with non-traumatic right upper quadrant abdominal pain from September 1, 2022, to March 6, 2023. The contribution of PoCUS to the diagnostic approach was evaluated using a proportion test assuming that 75% of diagnostic approaches would be better or comparable with PoCUS. Wilcoxon signed-rank tests evaluated the impact of PoCUS on the mean number of differential diagnoses, planned treatments, and complementary diagnostic tests. Overall, 60 (97%) diagnostic approaches were comparable or better with PoCUS (χ2 = 15.9, p < 0.01). With PoCUS, the mean number of differential diagnoses significantly decreased by 2.3 (95% CI - 2.7 to - 1.5) (p < 0.01), proposed treatments by 1.3 (95% CI - 1.8 to - 0.9) (p < 0.01), and complementary diagnostic tests by 1.3 (95% CI - 1.7 to - 1.0) (p < 0.01). These findings show that PoCUS positively impacts the diagnostic approach and significantly decreases the mean number of differential diagnoses, treatments, and complementary tests.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium.
| | - Alexandre Niset
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Claire Couvreur
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Laurent Marissiaux
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Félix Gendebien
- Emergency Department, Hôpital de Jolimont, Lobbes, Lobbes, Belgium
| | - Laurent Peyskens
- Emergency Department, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Boris Germeau
- Emergency Department, Cliniques Saint-Pierre Ottignies, Ottignies, Belgium
| | - Antoine Fasseaux
- Emergency Department, Hôpital de Jolimont, Lobbes, Haine Saint Paul, Belgium
| | | | - Andrea Penaloza
- Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Dominique Vanpee
- Institute of Health and Society and CHU UCL Namur, UCLOUVAIN, Ottignies-Louvain-la-Neuve, Belgium
| | - Xavier Bobbia
- Emergency Department, CHU Montpellier, Montpellier, France
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Panebianco N, Baston C. Training, Competency, and Interdisciplinary Collaboration in Point-of-Care Ultrasound. Semin Ultrasound CT MR 2024; 45:91-97. [PMID: 38056786 DOI: 10.1053/j.sult.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Point-of-care ultrasound can provide critical diagnostic information and add to procedural safety. As with any clinical skill, however, it must be applied by an adequately trained provider, with systems to ensure safety. Training can include a mix of hands-on training with traditional didactics, online coursework, and simulation, but each carries its own costs and benefits worth of review. Following training it is essential to think about assessment of competency in point-of-care ultrasound to reflect the combination of cognitive and procedural skills that makes up the practice. Within the frameworks described, expansion can be expected across specialty and professional boundaries.
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Affiliation(s)
- Nova Panebianco
- Perelman School of Medicine at the University of Pennsylvania, Department of Emergency Medicine, Philadelphia, PA.
| | - Cameron Baston
- Perelman School of Medicine at the University of Pennsylvania, Department of Medicine, Philadelphia, PA
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Dupriez F, Jarman RD. Normology: Is it Time to Rethink Point-of-Care Ultrasound Training? JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241232498. [PMID: 38357688 PMCID: PMC10865953 DOI: 10.1177/23821205241232498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Point-of-care ultrasound (PoCUS) is increasingly being adopted by clinicians to augment their clinical examination and aid procedures. Evidence-based clinical practice guidelines now support many aspects of PoCUS practice. As a result, more and more medical schools are integrating PoCUS into their curricula, creating a significant demand for training resources. All training must ensure that trainees have the appropriate knowledge, skills and behaviour to enable the clinical integration of PoCUS. The transition from supervised to unsupervised practice is an important step in PoCUS, but should not be confused with expertise. At the start of clinical practice, confirming that something is not normal is probably enough, and trainees can subsequently improve their PoCUS diagnostic accuracy at the bedside during clinical rotations. Our hypothesis is that competency can be achieved without the need to scan patients suspected or suffering from the target pathology. This would enable most of the training to be carried out outside the clinical environment, using volunteers in planned sessions. These planned sessions will be able to accommodate a larger number of trainees and may facilitate collaboration between specialties. When patients are scanned in the clinical environment, trainees should have acquired a good level of competence beforehand. In summary, normology principles could help PoCUS trainees, at the start of their training, to acquire the knowledge, skills and behaviour necessary to achieve a level of competency allowing them to proceed to unsupervised practice. Initially confirming whether something is normal or not is enough. Nevertheless, further research should be conducted to support this concept, and its impact on PoCUS teaching in clinical practice.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Robert David Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Steinwandel U, Coventry LL, Kheirkhah H. Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation. BMC MEDICAL EDUCATION 2023; 23:451. [PMID: 37337172 DOI: 10.1186/s12909-023-04428-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by clinicians from multiple disciplines worldwide, prior and during vascular access cannulations. While POCUS is a relatively new method to establish a vascular access in patients with complex vascular conditions, it is also essential to train and educate individuals who are novices in the techniques of cannulation so that they become proficient in performing this task subsequently on patients safely and successfully. A simulated environment may be a helpful tool to help healthcare providers establish skills in using POCUS safely and may also help them to successfully establish vascular access in patients. With this project, we sought to determine if participants of a simulated POCUS workshop for vascular access can use this technique successfully in their individual clinical environment after their attendance of a half-day workshop. METHODS A mixed-methods longitudinal study design was chosen to evaluate a point-of-care ultrasound workshop for peripheral intravenous cannula insertion. The workshops used simulation models for cannulation in combination with multiple ultrasound devices from various manufacturers to expose participants to a broader variety of POCUS devices as they may also vary in different clinical areas. Participants self-assessed their cannulation skills using questionnaires on a 10-point rating scale prior to and directly after the workshop. RESULTS A total of 85 Individuals participated in eleven half-day workshops through 2021 and 2022. Workshop participants claimed that attending the workshop had significantly enhanced their clinical skill of using ultrasound for the purpose of cannulating a venous vessel. The level of confidence in using this technique had increased in all participants directly after conclusion of the workshop. CONCLUSIONS Globally, clinicians are increasingly using POCUS to establish vascular access in patients, and it is necessary that they receive sufficient and adequately structured and formal training to successfully apply this technique in their clinical practice. Offering a workshop which uses simulation models in combination with various POCUS devices to demonstrate this technique in a hands-on approach has proven to be useful to establish this newly learned skill in clinicians.
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Affiliation(s)
- Ulrich Steinwandel
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia.
| | - Linda L Coventry
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Homa Kheirkhah
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia
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Cormack CJ, Childs J, Kent F. Point-of-Care Ultrasound Educational Development in Australasia: A Scoping Review. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1375-1384. [PMID: 36941181 DOI: 10.1016/j.ultrasmedbio.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/12/2023] [Accepted: 02/16/2023] [Indexed: 05/11/2023]
Abstract
Point-of-care ultrasound (PoCUS) technology is evolving rapidly and is being adopted by many health professionals in their clinical practice. Ultrasound is a complex skill requiring dedicated training. Appropriate integration of ultrasound education into medical, surgical, nursing and allied health professions is a current challenge worldwide. There are patient safety implications for use of ultrasound without adequate training and frameworks. The purpose of the review was to overview the status of PoCUS education in Australasia; investigate what is being taught and learned about ultrasound across the health professions; and identify potential gaps. The review was limited to postgraduate and qualified health professionals with established or emerging clinical use for PoCUS. A scoping review methodology was used to include literature in peer-reviewed articles, policies, guidelines, position statements, curricula and online material relating to ultrasound education. One hundred thirty-six documents were included. The literature revealed heterogeneity in ultrasound teaching and learning across the health professions. Several health professions lacked any defined scopes of practice, policies or curricula. Significant investment in resourcing ultrasound education is required to address the current needs in Australia and New Zealand.
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Affiliation(s)
- Carolynne J Cormack
- Monash University, Faculty of Medicine Nursing and Health Sciences, Victoria, Australia; Monash Health, Department of Medical Imaging, Victoria, Australia.
| | - Jessie Childs
- Faculty of Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Fiona Kent
- Monash University, Faculty of Medicine Nursing and Health Sciences, Victoria, Australia
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Dupriez F, de Castro BR, Gendebien F, Fasseaux A, Gensburger M, Marissiaux L, Penaloza A, Bobbia X, Jarman R. Is gallbladder PoCUS diagnostic accuracy accessible to medical students after PoCUS training exclusively on healthy volunteers? A pilot randomized control trial. Ultrasound J 2023; 15:18. [PMID: 37036612 PMCID: PMC10086079 DOI: 10.1186/s13089-023-00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/22/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Point-of-care ultrasound (PoCUS) is increasingly used in clinical practice and is now included in many undergraduate curricula. Here, we aimed to determine whether medical students who participated in a PoCUS teaching program with several practical training sessions involving healthy volunteers could achieve a good level of diagnostic accuracy in identifying gallbladder pathologies. The intervention group (IG) was trained exclusively on volunteers with a healthy gallbladder, whereas the control group (CG) had access to volunteers with a pathological gallbladder as recommended in most PoCUS curricula. MATERIALS AND METHODS Twenty medical students were randomly assigned to the IG and CG. After completing the training program over 2 months, students were evaluated by three independent examiners. Students and examiners were blind to group allocation and study outcome. Sensitivity and specificity of students' PoCUS gallstone diagnosis were assessed. Secondary outcomes were students' confidence, image quality, acquisition time, and PoCUS skills. RESULTS Sensitivity and specificity for gallstone diagnosis were, respectively, 0.85 and 0.97 in the IG and 0.80 and 0.83 in the CG. Areas under the curve (AUC) based on the receiver operating characteristic curve analysis were 0.91 and 0.82 in the IG and CG, respectively, with no significant difference (p = 0.271) and an AUC difference of -0.092. No significant between-group difference was found for the secondary outcomes. CONCLUSIONS Our pilot study showed that medical students can develop PoCUS diagnostic accuracy after training on healthy volunteers. If these findings are confirmed in a larger sample, this could favor the delivery of large practical teaching sessions without the need to include patients with pathology, thus facilitating PoCUS training for students.
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Affiliation(s)
- Florence Dupriez
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium.
| | | | - Félix Gendebien
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium
- Emergency Department, Hôpital de Jolimont - Lobbes, Lobbes, Belgium
| | - Antoine Fasseaux
- Emergency Department, Hôpital de Jolimont - Lobbes, Haine-Saint-Paul, Belgium
| | - Matthieu Gensburger
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Laurent Marissiaux
- Emergency Department, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Andrea Penaloza
- Emergency Department, Cliniques Universitaires Saint Luc, Av Hippocrate 10, 1200, Brussels, Belgium
| | - Xavier Bobbia
- Emergency Department, CHU Montpellier, Montpellier, France
| | - Robert Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle, UK
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8
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Ultrasound Examinations Performed by Registered Nurses in Obstetric, Gynecologic, and Reproductive Medicine Settings: Clinical Competencies and Education Guide, Fifth Edition. Nurs Womens Health 2023; 27:e12-e25. [PMID: 36759284 DOI: 10.1016/j.nwh.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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9
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Ultrasound Examinations Performed by Registered Nurses in Obstetric, Gynecologic, and Reproductive Medicine Settings: Clinical Competencies and Education Guide, Fifth Edition. J Obstet Gynecol Neonatal Nurs 2023; 52:e9-e22. [PMID: 36759268 DOI: 10.1016/j.jogn.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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10
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Maita H, Kobayashi T, Akimoto T, Hirano T, Osawa H, Kato H. Evaluation of simulation-based ultrasound education using a bladder simulator for medical students in Japan: a prospective observational study. J Med Ultrason (2001) 2023; 50:73-80. [PMID: 36445651 PMCID: PMC9892112 DOI: 10.1007/s10396-022-01269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/13/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed to investigate the usefulness of ultrasound education for medical students using a bladder simulator. METHODS This prospective observational study included volunteer fifth- and sixth-year medical students. An intravesical urine volume measurement simulator and a pocket-sized hand-held ultrasound device were used. The ultrasound education comprised pre-learning, briefing, simulation, debriefing, and learning summary. The simulation consisted of two tests: bladder simulator cube evaluation and scenario-based clinical application. A self-rated confidence score of 0-10 points along with reasons for the scores was recorded before and after the ultrasound education. RESULTS Twelve participants (median age, 23 years; female, 75%) met the inclusion criteria and were examined. Participants' bladder simulator cube evaluation and scenario-based clinical application test results were good, and the educational difficulty level was appropriate. The mean confidence scores for main unit operation, probe control, image acquisition, image evaluation and clinical application before the ultrasound education were 1.0, 1.8, 1.3, 0.8 and 0.1 points, respectively. The mean confidence scores after the ultrasound education were 5.8, 5.9, 5.4, 5.5 and 5.1, respectively, with significant increases for all items (p < 0.01). The positive impression categories that affected confidence scores after ultrasound education were related to device operation, image acquisition, image evaluation, clinical application and learning. CONCLUSION Ultrasound education using a bladder simulator increases confidence scores by imparting competencies related to device operation, image acquisition, image evaluation and clinical application, and it improves students' learning impression. This is a useful method for introductory ultrasound education for medical students.
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Affiliation(s)
- Hiroki Maita
- Development of Community Healthcare, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki-Shi, Aomori, 036-8562, Japan
| | - Tadashi Kobayashi
- Department of General Medicine, Hirosaki University School of Medicine and Hospital, 53 Hon-Cho, Hirosaki-Shi, Aomori, 036-8563, Japan.
| | - Takashi Akimoto
- Department of General Medicine, Hirosaki University School of Medicine and Hospital, 53 Hon-Cho, Hirosaki-Shi, Aomori, 036-8563, Japan
| | - Takahiro Hirano
- General Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki-Shi, Aomori, 036-8562, Japan
| | - Hiroshi Osawa
- Department of General Medicine, Hirosaki University School of Medicine and Hospital, 53 Hon-Cho, Hirosaki-Shi, Aomori, 036-8563, Japan
| | - Hiroyuki Kato
- Development of Community Healthcare, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki-Shi, Aomori, 036-8562, Japan
- Department of General Medicine, Hirosaki University School of Medicine and Hospital, 53 Hon-Cho, Hirosaki-Shi, Aomori, 036-8563, Japan
- General Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki-Shi, Aomori, 036-8562, Japan
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Miharu M, Nobuko H, Hiromitsu K. Short- and long-term reproducibility of peripheral superficial vein depth and diameter measurements using ultrasound imaging. BMC Med Imaging 2022; 22:212. [DOI: 10.1186/s12880-022-00945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Abstract
Background
Ultrasound imaging is used for diagnosis, treatment, and blood vessel visualization during venous catheter placement. However, various physiological factors (e.g., body temperature and exercise) influence vein diameters, which are expected to exhibit daily or diurnal fluctuations. Therefore, this study aimed to determine the intraday (short-term) and interday (long-term) reproducibility of repeated measurements of the depth and diameter of peripheral superficial veins.
Methods
Twenty-three healthy young women (mean age, 21.7 ± 0.8 years) participated in the study to examine the short- and long-term reproducibility of the depth and diameter of the cutaneous vein in the left elbow fossa acquired by ultrasound imaging. Short-term measurement intervals were 10 s, and the probe was released from the skin for each acquisition, which was repeated five consecutive times. Long-term measurements were performed at the same time on the next day following the same procedure. The acquired images were analyzed for vein depth and diameter using ImageJ software. The intraclass correlation coefficient (ICC) was calculated to determine the short- and long-term reproducibility of the measurements. The relationship between the venous depth and venous diameter intra-individual variation was analyzed, as well as the influence of body composition (body fat and muscle mass) on the venous diameter and depth.
Results
For vein depth measurements, the short- and long-term ICCs were 0.94–0.96 and 0.88, respectively. For the vein diameter, the short- and long-term ICCs were 0.94–0.97 and 0.67, respectively. The short-term ICCs for both vein depth and diameter exceeded 0.9, indicating that the ultrasound vascular measurement was sufficiently reliable. However, long-term reproducibility was slightly lower, especially for the vein diameter. No correlation was found between the intra-individual variation of the vein diameter and vein depth. Although the vein diameter and body fat mass uncorrelated, the vein depth and body fat mass significantly correlated (r = 0.675, 95% confidence interval = 0.281–0.830).
Conclusions
The long-term reproducibility of vein diameters was somewhat lower than that of the short-term reproducibility. This could be attributed to fluctuations in the physiological state of the participant rather than to the instability of the measurement. Therefore, ultrasound measurement of the peripheral superficial vein is sufficiently reliable.
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van Hoving DJ, Alenyo AN, Komagum F, Lamprecht H. Current use and perceived barriers of emergency point-of-care ultrasound by African health care practitioners. Afr J Emerg Med 2022; 12:333-338. [PMID: 35967088 PMCID: PMC9363966 DOI: 10.1016/j.afjem.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/06/2022] [Accepted: 07/24/2022] [Indexed: 12/04/2022] Open
Abstract
Point-of-care ultrasound is a key skill for emergency care practitioners in Africa. Access barriers to point-of-care ultrasound training and equipment are still relevant in Africa. Many users of point-of-care ultrasound in Africa have not been formally credentialed. A potential discordance exists between local burden of disease and point-of-care ultrasound training.
Introduction The African Federation of Emergency Medicine (AFEM) recommends the use of emergency point-of-care ultrasound (ePOCUS) as a core skill for health care practitioners in Africa. The study explored the use of ePOCUS by health care practitioners among AFEM members who work across Africa. Methods An anonymous online survey was distributed to individual members of AFEM and affiliated organisations. The questionnaire was tested by the AFEM Scientific Committee for potential content modifications prior to distribution. Summary statistics are presented. Results Of the 220 participants that were analysed, 148 (67.3%) were using ePOCUS. The mean age was 36 years; 146 (66%) were male; and 198 (90%) obtained their primary medical qualification in Africa. In total, 168 (76%) were doctors, and most participants (n = 204, 93%) have worked in Africa during the last 5 years. Reasons for not using ePOCUS mainly related to lack of training and problems with ultrasound machines or consumables. Most ePOCUS users (116/148, 78%) attended courses with hands-on training, but only 65 (44%) participants were credentialed (by 18 different organizations). The median score for self-perceived level of ePOCUS skills was 75 in credentialed users versus 50 in those that were not credentialed. Ultrasound in trauma was the most frequently used module (n = 141, 99%), followed by focused cardiac assessment (n = 128, 90%) and thoracic (including lung) assessment (n = 128, 90.1%). The FASH-module (Focused Assessment with Sonography for HIV/TB) was the least used (n = 69, 49%). Conclusion Access barriers to ePOCUS training, mentorship, equipment and consumables are still relevant in Africa. The low credentialing rate and the potential discordance between local burden of disease and ePOCUS training requires further investigation.
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Affiliation(s)
| | | | - Faith Komagum
- Department of Emergency Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hein Lamprecht
- Division of Emergency Medicine, Stellenbosch University, Cape Town, South Africa
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Rath KA, Bonomo JB, Ballman K. Point-of-Care Ultrasonography for Advanced Practice Providers: A Training Initiative. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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