Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, England.
School of Computer Science, College of Science, University of Lincoln, Lincoln, England.
BMC Health Serv Res. 2023 Jan 25;23(1):84. doi: 10.1186/s12913-023-09069-4.
Implementing Point-of-care ultrasound (POCUS) in community practice could help to decide upon and prioritise initial treatment, procedures and appropriate specialist referral or conveyance to hospital. A recent literature review suggests that image quality, portability and cost of ultrasound devices are all improving with widening indications for community POCUS, but evidence about community POCUS use is needed in the UK. We aimed to explore views of clinical practitioners, actively using ultrasound, on their experiences of using POCUS and potential facilitators and barriers to its wider implementation in community settings in the UK.
We conducted a qualitative interview study with practitioners from community and secondary care settings actively using POCUS in practice. A convenience sample of eligible participants from different clinical specialties and settings was recruited using social media adverts, through websites of relevant research groups and snowball sampling. Individual semi-structured interviews were conducted online using Microsoft Teams. These were recorded, transcribed verbatim, and analysed using a Framework approach supported by NVivo 12.
We interviewed 16 practitioners aged between 40 and 62 years from different professional backgrounds, including paramedics, emergency physicians, general practitioners, and allied health professionals. Participants identified key considerations and facilitators for wider implementation of POCUS in community settings in the UK: resource requirements for deployment and support of working devices; sufficient time and a skilled workforce; attention to training, education and support needs; ensuring proper governance, guidelines and quality assurance; workforce considerations; enabling ease of use in assisting decision making with consideration of unintended consequences; and more robust evidence to support perceptions of improved patient outcomes and experience.
POCUS could be useful for improving patient journey and health outcomes in community care, but this requires further research to evaluate outcomes. The facilitators identified could help make community POCUS a reality.
在社区实践中实施即时超声检查（POCUS）可以帮助确定和优先考虑初始治疗、程序以及适当的专科转诊或送往医院。最近的文献综述表明，随着 POCUS 在社区中适应证的不断扩大，超声设备的图像质量、便携性和成本都在不断提高，但英国需要有关社区 POCUS 使用的证据。我们旨在探讨在社区环境中积极使用超声的临床医生对其使用 POCUS 的经验的看法，以及其在社区环境中更广泛实施的潜在促进因素和障碍。
我们对来自社区和二级保健机构的积极在实践中使用 POCUS 的从业者进行了定性访谈研究。通过社交媒体广告、相关研究小组的网站和滚雪球抽样，从不同临床专业和环境中招募了具有资格的参与者作为方便样本。使用 Microsoft Teams 在线进行了个人半结构化访谈。对访谈进行了录音、逐字转录，并使用 NVivo 12 支持的框架方法进行了分析。
我们采访了来自不同专业背景的 16 名年龄在 40 至 62 岁之间的从业者，包括护理人员、急诊医生、全科医生和辅助医疗专业人员。参与者确定了在英国社区环境中更广泛实施 POCUS 的关键考虑因素和促进因素：部署和支持工作设备的资源要求；足够的时间和熟练的劳动力；关注培训、教育和支持需求；确保适当的治理、指南和质量保证；劳动力考虑因素；易于使用以帮助考虑意外后果的决策；以及更有力的证据支持改善患者结局和体验的观念。
POCUS 可以有助于改善社区护理中的患者就医流程和健康结局，但这需要进一步的研究来评估结果。确定的促进因素可以帮助实现社区 POCUS。
