Jensen Trevor P, Soni Nilam J, Tierney David M, Lucas Brian P
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Division of Hospital Medicine, Department of Medicine, University of Texas Health School of Medicine at San Antonio, San Antonio, Texas, USA.
J Hosp Med. 2017 Oct;12(10):836-839. doi: 10.12788/jhm.2837. Epub 2017 Sep 6.
Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privileging practices for bedside procedures and how those practices are perceived. Only half of all experts reported their hospitals require a minimum number of procedures performed to grant initial (48%) and ongoing (52%) privileges for bedside procedures. Regardless, most experts thought minimums should be higher than those in current practice and should exist alongside direct observation of manual skills. Experts reported that the use of ultrasound guidance was nearly universal for paracentesis, thoracentesis, and central venous catheter placement, but only 10% of hospitals required the use of ultrasound for initial privileging of these procedures.
许多住院医师通常被授予在床边进行侵入性操作的医院特权，但授予特权的标准并未得到很好的描述。我们对来自医院医学学会床旁超声特别工作组的21位住院医师操作专家进行了一项调查，以更好地了解当前床边操作的特权授予做法以及这些做法的看法。所有专家中只有一半报告称，他们所在的医院要求进行最低数量的操作才能授予床边操作的初始（48%）和持续（52%）特权。尽管如此，大多数专家认为最低操作数量应高于当前的做法，并且应该与对手动技能的直接观察同时存在。专家们报告说，在腹腔穿刺术、胸腔穿刺术和中心静脉导管置入术中，超声引导的使用几乎是普遍的，但只有10%的医院要求在这些操作的初始特权授予中使用超声。
