Lucas Brian P, Tierney David M, Jensen Trevor P, Dancel Ria, Cho Joel, El-Barbary Mahmoud, Franco-Sadud Ricardo, Soni Nilam J
Medicine Service, White River Junction VA Medical Center, White River Junction, Vermont, USA.
Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.
J Hosp Med. 2018 Feb 1;13(2):117-125. doi: 10.12788/jhm.2917. Epub 2018 Jan 18.
Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing. Given variation in training and experience, such assessments are not straightforward "sign offs." We thus convened a panel of experts to conduct a systematic review to provide recommendations for credentialing hospitalist physicians in ultrasound guidance of these 6 bedside procedures. Pathways for initial and ongoing credentialing are proposed. A guiding principle of both is that certification assessments for basic competence are best made through direct observation of performance on actual patients.
超声引导越来越多地用于执行以下6种床边操作，这些操作是住院医师的核心能力：腹腔穿刺术、动脉导管置入、关节腔穿刺术、中心静脉导管置入、腰椎穿刺和胸腔穿刺。然而，大多数住院医师尚未获得专业委员会或其所在医院以外的其他机构的认证来执行这些操作，无论是否使用超声引导。相反，医院特权委员会通常要求住院医师团队负责人进行临时的院内认证评估作为资格认定的一部分。鉴于培训和经验的差异，此类评估并非简单的“签字批准”。因此，我们召集了一个专家小组进行系统综述，以提供关于对执行这6种床边操作的住院医师进行超声引导资格认定的建议。提出了初始资格认定和持续资格认定的途径。两者的一个指导原则是，对基本能力的认证评估最好通过直接观察在实际患者身上的操作表现来进行。
