Reeve Ruth, Higginson Antony, Ball Christopher, Beable Richard, Smith Mike
Portsmouth University Hospital NHS trust, Portsmouth, UK.
University of Southampton, Southampton, UK.
Ultrasound. 2023 Feb;31(1):4-10. doi: 10.1177/1742271X221102577. Epub 2022 Jun 20.
Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles.
This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound. The authors illustrate this via the example of a gastrointestinal ultrasound role, developed in an NHS department.
The framework approach comprises three elements, each interdependent upon and inform each other: (A) Scope of practice, (B) Education and competency and (C) Governance. (A) Defines (and communicates) the role extension and area(s) of subsequent ultrasound imaging, interpretation and reporting. By identifying the why, how and what is required this informs (B) the education and assessment of competency for those taking on new roles or areas of expertise. (C) Is informed by (A) and is an ongoing process of quality assurance to safeguard high standards in clinical care. In supporting role extension, this approach can facilitate new workforce configurations, skill expansion and enable increasing service demands to be met.
By defining and aligning the components of scope of practice, education/competency and governance, role development in ultrasound can be initiated and sustained. Role extension utilising this approach brings benefits for patients, clinicians and departments.
对于医疗保健专业人员而言，将角色扩展到超声实践的新领域可能具有挑战性。向现有高级实践领域的扩展通常通过既定流程和认可培训来进行；然而，在没有正规培训的领域，对于如何发展新的进步临床角色可能缺乏支持。
本文介绍了使用框架方法来确定高级实践领域如何能够支持个人和部门在超声领域安全且成功地发展新角色。作者通过在国民保健服务体系（NHS）部门中发展的胃肠超声角色这一实例进行说明。
框架方法包含三个要素，每个要素相互依存且相互影响：（A）实践范围，（B）教育与能力，以及（C）治理。（A）定义（并传达）角色扩展以及后续超声成像、解读和报告的领域。通过确定所需的原因、方式和内容，这为（B）承担新角色或专业领域人员的教育和能力评估提供了依据。（C）受（A）影响，是一个持续的质量保证过程，以保障临床护理的高标准。在支持角色扩展方面，这种方法可以促进新的劳动力配置、技能扩展，并满足不断增加的服务需求。
通过定义和协调实践范围、教育/能力和治理的组成部分，可以启动并维持超声领域的角色发展。利用这种方法进行角色扩展对患者、临床医生和部门都有好处。
