College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Canadian Centre for Rural and Agriculature Health, College of Medicine, University of Sasatkchewan , Saskatoon, SK, Canada.
Can J Rural Med. 2023 Oct-Dec;28(4):170-178. doi: 10.4103/cjrm.cjrm_90_22.
Point-of-care ultrasound (PoCUS) has been recognised as a tool that leads to more definitive diagnoses and enhances clinical decision-making in rural emergency departments (EDs) where diagnostic imaging is limited. We aimed to determine the current utilisation, barriers and solutions to using PoCUS in this rural Saskatchewan ED.
Physicians working in the ED participated in a semi-structured interview. An online survey, administered via SurveyMonkey post-interview to provide further context, was used to support qualitative approaches. Interviews were recorded, transcribed and then analysed using inductive interpretation.
Seven physicians completed the quantitative survey with a response rate of 70%. Ten physicians were interviewed with a response rate of 100%. Themes identified were that physicians in this community's ED perceived their skill level as determining whether a scan was diagnostic or not, rather than the specific PoCUS application itself. In addition, they performed scans primarily for the purpose of triage. Inadequate training, Core IP certification certification requirement and intradepartmental logistics were barriers to PoCUS utilisation.
This study showed that ED physicians in this community perceived PoCUS as a clinical adjunct and as a tool to triage patients for further imaging. Results highlight the need to have accessible training for rural physicians to increase PoCUS utilisation, awareness of current Saskatchewan PoCUS guidelines and education on diagnostic applications of PoCUS. Increased use of PoCUS for specific scans could decrease the need for formal imaging and the associated healthcare system resources.
床边超声（PoCUS）已被公认为一种工具，可在诊断成像受限的农村急诊部（ED）中做出更明确的诊断并增强临床决策。我们旨在确定在萨斯喀彻温省农村 ED 中使用 PoCUS 的当前使用情况、障碍和解决方案。
在 ED 工作的医生参加了半结构化访谈。在访谈后通过 SurveyMonkey 在线调查提供进一步的背景信息，使用该调查来支持定性方法。访谈进行了录音、转录，然后使用归纳解释进行分析。
7 名医生完成了定量调查，回复率为 70%。对 10 名医生进行了访谈，回复率为 100%。确定的主题是，该社区 ED 的医生认为他们的技能水平决定了扫描是否具有诊断意义，而不是特定的 PoCUS 应用本身。此外，他们主要出于分诊目的进行扫描。培训不足、核心 IP 认证要求和部门内部物流是阻碍 PoCUS 使用的障碍。
本研究表明，该社区的 ED 医生将 PoCUS 视为临床辅助工具，也是分诊患者进行进一步影像学检查的工具。结果强调需要为农村医生提供便捷的培训，以增加 PoCUS 的使用，提高对萨斯喀彻温省 PoCUS 指南的认识以及对 PoCUS 诊断应用的教育。更频繁地使用 PoCUS 进行特定扫描可以减少对正式成像的需求和相关的医疗保健系统资源。
