Bennett Courtney E, Samavedam Sandhya, Jayaprakash Namita, Kogan Alexander, Gajic Ognjen, Sekiguchi Hiroshi
Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Division of Pulmonary and Critical Care Medicine, Rochester, USA.
Cardiovasc Ultrasound. 2018 Sep 11;16(1):14. doi: 10.1186/s12947-018-0132-0.
The purpose of this study was to determine the ideal timing for providers to perform point-of-care ultrasound (POCUS) with the least increase in workload.
We conducted a pilot crossover study to compare 2 POCUS-assisted evaluation protocols for acutely ill patients: sequential (physical examination followed by POCUS) vs parallel (POCUS at the time of physical examination). Participants were randomly assigned to 2 groups according to which POCUS-assisted protocol (sequential vs parallel) was used during simulated scenarios. Subsequently, the groups were crossed over to complete assessment by using the other POCUS-assisted protocol in the same patient scenarios. Providers' workloads, measured with the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and time to complete patient evaluation, were compared between the 2 protocols.
Seven providers completed 14 assessments (7 sequential and 7 parallel). The median (IQR) total NASA-TLX score was 30 (30-50) in the sequential and 55 (50-65) in the parallel protocol (P = .03), which suggests a significantly lower workload in the sequential protocol. When individual components of the NASA-TLX score were evaluated, mental demand and frustration level were significantly lower in the sequential than in the parallel protocol (40 [IQR, 30-60] vs 50 [IQR, 40-70]; P = .03 and 25 [IQR, 20-35] vs 60 [IQR, 45-85]; P = .02, respectively). The time needed to complete the assessment was similar between the sequential and parallel protocols (8.7 [IQR, 6-9] minutes vs 10.1 [IQR, 7-11] minutes, respectively; P = .30).
A sequential POCUS-assisted protocol posed less workload to POCUS operators than the parallel protocol.
本研究的目的是确定能使医护人员在工作量增加最少的情况下进行床旁超声检查（POCUS）的理想时机。
我们进行了一项试点交叉研究，以比较两种针对急性病患者的POCUS辅助评估方案：序贯式（体格检查后进行POCUS）与平行式（体格检查时同时进行POCUS）。参与者根据在模拟场景中使用的POCUS辅助方案（序贯式与平行式）被随机分为两组。随后，两组交叉，在相同的患者场景中使用另一种POCUS辅助方案完成评估。比较了两种方案中医护人员的工作量（用美国国家航空航天局任务负荷指数（NASA-TLX）衡量）以及完成患者评估所需的时间。
7名医护人员完成了14次评估（7次序贯式和7次平行式）。序贯式方案的NASA-TLX总评分中位数（IQR）为30（30 - 50），平行式方案为55（50 - 65）（P = 0.03），这表明序贯式方案的工作量显著更低。当评估NASA-TLX评分的各个组成部分时，序贯式方案中的精神需求和挫败感水平显著低于平行式方案（分别为40[IQR，30 - 60]对50[IQR，40 - 70]；P = 0.03和25[IQR，20 - 35]对60[IQR，45 - 85]；P = 0.02）。序贯式和平行式方案完成评估所需的时间相似（分别为8.7[IQR，6 - 9]分钟对10.1[IQR，7 - 11]分钟；P = 0.30）。
与平行式方案相比，序贯式POCUS辅助方案给POCUS操作人员带来的工作量更少。
