Yamada Toru, Kimura Takuma, Shigetomi Kyoko, Shinohara Takahiro, Ouchi Shuji, Mabuchi Suguru, Kusama Tomoko, Ishida Takeshi, Hashimoto Masayoshi
Department of General Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Department of R&D Innovation for Home Care Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Bunkyo-ku, Tokyo, 113-8510, Japan.
Ultrasound J. 2025 Jan 10;17(1):1. doi: 10.1186/s13089-025-00399-4.
Point-of-care ultrasound (POCUS) is a valuable skill for generalist physicians, nurse practitioners (NPs), and nurses; however, its utilization remains limited. This study was performed to investigate the current status, barriers, and facilitators of POCUS implementation among physicians, NPs, and nurses in family and hospital medicine in Japan and to identify differences in influencing factors between physicians and NPs/nurses.
A web-based survey was distributed via the mailing lists of four major academic societies in general medicine in Japan-the Japanese Society of Hospital General Medicine, the Japan Primary Care Association, the Japanese Association for Home Care Medicine, and the Japan Society of Nurse Practitioner-from April to June 2024. The respondents included physicians, NPs, and nurses affiliated with these societies. Responses from other professions, duplicate entries, and incomplete surveys were excluded from the analysis, resulting in 913 valid responses (692 physicians and 221 NPs/nurses). Physicians reported a higher POCUS implementation rate than NPs/nurses (73.0 vs. 63.4%, p = 0.006). The top two barriers were consistent across both groups: lack of training opportunities (p = 0.385) and lack of image acquisition skills (p = 0.369). However, NPs/nurses reported significantly greater barriers than did physicians, including lack of mentors (p < 0.001), lack of interpretation skills (p = 0.007), lack of confidence (p < 0.001), poor access to ultrasound devices (p < 0.001), and absence of institutional guidelines (p < 0.001). The top facilitators for both groups were good access to ultrasound devices (p = 0.078) and increased training opportunities (p = 0.240), with no significant differences between them. Compared with physicians, NPs/nurses expressed a significantly higher demand for nearby mentors (p < 0.001), institutional support (p < 0.001), and POCUS certification (p = 0.005).
There is currently a lack of POCUS training opportunities across all professional roles. To promote POCUS adoption among NPs and nurses, it is essential to develop mentorship programs, establish institutional guidelines, and create an environment that enables NPs and nurses to perform POCUS confidently through measures such as certification programs.
即时超声检查（POCUS）对全科医生、执业护士（NPs）和护士来说是一项有价值的技能；然而，其应用仍然有限。本研究旨在调查日本家庭医学和医院医学领域的医生、NPs和护士实施POCUS的现状、障碍和促进因素，并确定医生与NPs/护士在影响因素上的差异。
2024年4月至6月，通过日本四个主要普通医学学术团体——日本医院普通医学学会、日本初级保健协会、日本家庭护理医学协会和日本执业护士学会的邮件列表进行了一项基于网络的调查。受访者包括隶属于这些团体的医生、NPs和护士。分析排除了其他职业的回复、重复条目和不完整的调查，最终得到913份有效回复（692名医生和221名NPs/护士）。医生报告的POCUS实施率高于NPs/护士（73.0%对63.4%，p = 0.006）。两组的前两大障碍是一致的：缺乏培训机会（p = 0.385）和缺乏图像采集技能（p = 0.369）。然而，NPs/护士报告的障碍明显比医生更多，包括缺乏指导者（p < 0.001）、缺乏解读技能（p = 0.007）、缺乏信心（p < 0.001）、难以获得超声设备（p < 0.001）以及缺乏机构指南（p < 0.001）。两组的首要促进因素都是易于获得超声设备（p = 0.078）和增加培训机会（p = 0.240），两者之间无显著差异。与医生相比，NPs/护士对附近指导者（p < 0.001）、机构支持（p < 0.001）和POCUS认证（p = 0.005）的需求明显更高。
目前所有专业角色都缺乏POCUS培训机会。为了促进NPs和护士采用POCUS，必须制定指导计划、建立机构指南，并通过认证计划等措施创造一个能让NPs和护士自信地进行POCUS操作的环境。
