Eke Onyinyechi F, Umoga Kelechi, Morone Christina, Shokoohi Hamid, Liteplo Andrew, Haberer Jessica
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
Intern Emerg Med. 2024 Nov 5. doi: 10.1007/s11739-024-03809-y.
Point-of-care ultrasound (POCUS) has been shown to be beneficial in facilitating patient care, but its adoption is variable among emergency medicine (EM) clinicians. We identified the patterns of POCUS use and gaps in POCUS integration in a tertiary care emergency department (ED). These data provide a user-centered platform for subsequent development of a tele-ultrasound (tele-US) consultation program. We developed a 25-item needs assessment survey and used a 5-point Likert scale to assess current patterns of POCUS use and potential needs for POCUS among EM clinicians. Data were analyzed descriptively, and a chi-square analysis was used to assess for differences in POCUS use and comfort levels among clinicians. Overall, 48% (91/190) of eligible providers responded to the survey. Clinician responders included 38% (35/91) attendings (including fellows), 29% (26/91) residents, and 33% (30/91) advance practice providers (APPs). In assessing needs, 70% (58/83) of clinicians noted they would use POCUS more if they had more training. 76% (63/83) of clinicians felt comfortable with image acquisition and 68% (56/83) with image interpretation. APPs were less comfortable with POCUS image interpretation and clinical integration of POCUS findings compared to residents (χ: 16.3, p < 0.0001 and χ: 5.1, p = 0.02, respectively). 65% (54/83) of clinicians would use POCUS more if real-time supervision via tele-US was available for image acquisition and image interpretation. EM clinicians indicated a substantial need for further real-time POCUS training and supervision, especially for image interpretation. A clinician-centered strategy, such as tele-US, has potential to increase proficient use of POCUS.
床旁超声（POCUS）已被证明有助于促进患者护理，但在急诊医学（EM）临床医生中的采用情况各不相同。我们确定了三级医疗急诊科（ED）中POCUS的使用模式以及POCUS整合方面的差距。这些数据为后续开发远程超声（tele-US）咨询项目提供了一个以用户为中心的平台。我们制定了一份包含25个项目的需求评估调查问卷，并使用5点李克特量表来评估EM临床医生当前POCUS的使用模式以及对POCUS的潜在需求。对数据进行描述性分析，并使用卡方分析来评估临床医生在POCUS使用和舒适度方面的差异。总体而言，48%（91/190）符合条件的提供者回复了调查。临床医生回复者包括38%（35/91）的主治医师（包括研究员）、29%（26/91）的住院医师以及33%（30/91）的高级实践提供者（APP）。在评估需求时，70%（58/83）的临床医生表示，如果接受更多培训，他们会更多地使用POCUS。76%（63/83）的临床医生对图像采集感到满意，68%（56/83）的临床医生对图像解读感到满意。与住院医师相比，APP在POCUS图像解读和POCUS检查结果的临床整合方面不太满意（卡方值分别为：16.3，p < 0.0001和5.1，p = 0.02）。65%（54/83）的临床医生表示，如果通过远程超声进行图像采集和图像解读的实时监督可用，他们会更多地使用POCUS。EM临床医生表示非常需要进一步的实时POCUS培训和监督，尤其是图像解读方面。以临床医生为中心的策略，如远程超声，有可能提高POCUS的熟练使用程度。
