Life after a point-of-care ultrasound course: setting up the right conditions!

Olgers, Tycho J; Azizi, Nasim; Bouma, Hjalmar R.; Maaten, Jan C. ter

doi:10.1186/s13089-020-00190-7

Cited by 10 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The GPs in our study called for more supervision to be included in training programmes. In addition, lack of time to practice was mentioned as a barrier, which has also been found in hospital settings [ 24 , 25 ]. Even though the GPs did not consider it, the low prevalence of patients in general practice with conditions suited for POCUS examinations [ 11 ] may further challenge the opportunities for developing tacit knowledge.…”

Section: Discussionmentioning

confidence: 99%

Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study

Andersen

Espersen

Brodersen

et al. 2022

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

Background Point-of-care ultrasonography (POCUS) is increasingly used in general practice despite the lack of official educational programmes or guidelines for general practitioners (GPs). Aim To explore how GPs have learnt to use POCUS and which barriers they have encountered in their learning process. Design and setting Qualitative study conducted in office-based general practice in Denmark. Methods Semi-structured interviews were conducted with 13 GPs who had implemented POCUS without supporting guidelines or regulations. Analysis was carried out using systematic text condensation. The interview data for this study were collected along with data used in a previous study. Results The participating GPs described having composed their own ultrasound education following a continuous learning process. Basic POCUS competences were achieved through formalized training sessions at hospital departments or courses. The GPs further developed and expanded their scanning skills through additional courses and continuous self-study practice on patients often while consulting internet sources, textbooks or colleagues. Lack of available ultrasound courses, supervision, and clinical guidelines together with time constraints and financial aspects were mentioned as barriers to their ultrasound training. Conclusion This study showed how GPs had composed their own ultrasound education individually and differently, guided by their own experiences and beliefs about good clinical practice. Formalized ultrasound training was considered a prerequisite for achieving basic ultrasound competences while continuous practice was considered paramount to develop and maintain scanning skills. There were several obstacles to overcome in the learning process including lack of supervision, guidance, and opportunity for practicing skills. Key points Little is known about the educational needs of general practitioners striving to achieve ultrasound competences. General practitioners described using formalized training to achieve basic scanning competences and continuous self-study and practice to further develop their skills. Lack of time, supervision, clinical guidelines and ultrasound courses were considered barriers in the learning process together with financial aspects.

show abstract

Section: Discussionmentioning

confidence: 99%

Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study

Andersen

Espersen

Brodersen

et al. 2022

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

show abstract

“…To better examine the needs and potential advantages in different areas, we divided the participants into four groups consisting of PCPs, GPs, EPs, and PCNs. Despite the broad application of HH-POCUS in EDs 18 19 20 21 , due to bureaucratic hurdles, EPs recruited only seven patients within four months and therefore were not included in the analysis.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory Use of Handheld Point-of-Care Ultrasound (HH-POCUS) in Rural Brandenburg – A Pilot Study

Frauendorf²,

Wischke

et al. 2021

Ultraschall Med

View full text Add to dashboard Cite

Purpose This study aims to evaluate the use of handheld ultrasound devices (HHUS) for point-of-care ultrasound (POCUS) to improve outpatient care in rural Brandenburg. Materials and Methods A group of general practitioners (n = 9), palliative care physicians (n = 6), emergency physicians (n = 4), and nurses from palliative care services (n = 5) participated in this study. Following a 3-hour workshop and 2 weeks of individual training, participants performed POCUS using HHUS (HH-POCUS). Indications, examination results, and resulting treatment changes (e. g., acute interventions, new medication) were documented in a standardized data entry form. Results 19 physicians with different ultrasound experience and 5 palliative care nurses attended the workshop program and took part in the study. Three of the participating physicians were out of training in ultrasound and received prolonged supervision. Among 427 HH-POCUS examinations, the FAST scan and kidney scan were performed most often. Pain and dyspnea were the most common indications for HH-POCUS. Among the examinations performed by physicians (n = 311), ascites was the most common pathology (27 % of cases). Using a simplified examination protocol, palliative care nurses diagnosed fluid collections, hydronephrosis and transurethral catheter position or urinary retention. In 80.4 % of physician-performed cases, HH-POCUS made a valuable impact on patient management. HH-POCUS contributed to treatment decisions in 49.5 % of cases, including a change of medication in 29.6 % and performance of therapeutic interventions in 19.9 %. Hospital admission or referral to an ambulatory specialist was initiated due to HH-POCUS findings in 17.7 % of patients. Conclusion HH-POCUS helped doctors in rural areas to optimize patient care through rapid on-site collection of therapeutically relevant findings. In addition, it was shown that specialized and motivated nurses can independently detect simple ultrasound findings and thus provide clinically relevant information to doctors.

show abstract

“…The feasibility of right ventricle assessment by echocardiography has spread from cardiology to emergency departments, critical care, and acute care units, due to the improved skill of physicians and to the availability of portable point-of-care echocardiography. 32 33 Moreover, contemporary protocols for the management of patients referred for dyspnea or chest pain include troponin and/or BNP testing.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Management and Clinical Course of Acute Pulmonary Embolism: The COPE Study

et al. 2023

View full text Add to dashboard Cite

Background. New diagnosis, risk stratification and treatment strategies became recently available for patients with acute pulmonary embolism (PE) leading to changes in clinical practice and potentially influencing short-term patients’ outcomes. Research question. The COntemporary management of PE (COPE) study is aimed at assessing the contemporary clinical management and outcomes in patients with acute symptomatic PE. Study design and Methods Prospective, non-interventional, multicentre study. The co-primary study outcomes, in-hospital and 30-day death, were reported overall and by risk categories according to the ESC and AHA guidelines. Results Among 5,213 study patients, PE was confirmed by computed tomography in 96.3%. In-hospital, 289 patients underwent reperfusion (5.5%), 92.1% received parenteral anticoagulants; at discharge, 75.6% received direct oral anticoagulants and 6.7% vitamin K antagonists. In-hospital and 30-day mortality were 3.4% and 4.8%, respectively. In-hospital death occurred in 20.3% high-risk patients (n=177), in 4.0% intermediate-risk patients (n=3281) and in 0.5% low-risk patients (n=1702) according to ESC guidelines. Further stratification in intermediate-high and intermediate-low risk patients did not reach statistical significance; intermediate-risk patients with sPESI>0 alone had lower mortality compared to those with one or both among RVD at echocardiography or increased troponin. Death or clinical deterioration occurred in 1.5%, 5.0% and 9.4% of patients at low, intermediate-low and intermediate-high risk for death according to ESC guidelines. Interpretation. For the majority of patients with PE, contemporary initial management includes risk stratification and treatment with direct oral anticoagulants. In-hospital mortality remains high in intermediate and high-risk patients calling for and informing research focused on its reduction.

show abstract

Life after a point-of-care ultrasound course: setting up the right conditions!

Cited by 10 publications

References 15 publications

Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study

Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study

Ambulatory Use of Handheld Point-of-Care Ultrasound (HH-POCUS) in Rural Brandenburg – A Pilot Study

Contemporary Management and Clinical Course of Acute Pulmonary Embolism: The COPE Study

Contact Info

Product

Resources

About