Point of care ultrasound in pelvic health: scope of practice, education and governance for physiotherapists

Abstract

Pelvic health and pelvic floor dysfunction have wide-reaching implications across a range of patient groups. Placing ultrasound imaging into the hands of assessing and treating clinicians (i.e. point of care ultrasound, PoCUS) can provide a step change in clinical effectiveness and efficiency. Pelvic floor dysfunction is managed by one or more members of a multi-disciplinary team that includes physiotherapists. Physiotherapists’ involvement includes diagnosis, patient education, identifying shared treatment goals, using rehabilitative strategies and empowering patients through self-management. Drawing upon existing publications in this area and applying framework principles, the authors propose a clinical and sonographic scope of practice for physiotherapists as part of supporting the consolidation and expansion of pelvic health PoCUS. Education and governance considerations are detailed to ensure the robust and safe use of this modality. Alongside empowering the use of ultrasound imaging by clinicians such as physiotherapists in the UK and internationally, we provide clarity to other members of the care pathway and ultrasound imaging professionals.

A proposed framework for point of care musculoskeletal ultrasound and ultrasound image-guided interventions by physiotherapists: scope of practice, education and governance

“…The PoCUS framework approach was devised by the lead author (stemming from longstanding work across a range of sonography and PoCUS specialities in the domains of education, work-force planning, policy and legislation) in response to a perceived need to provide comprehensive solutions for PoCUS integration into healthcare systems. It has been recently used to support PoCUS expansion and consolidation for non-physiotherapy professions (Speech and Language Therapy [ 18 ] and Sonography scope expansion [ 19 ]) and physiotherapy specialisms such as lung/critical care [ 7 ] and pelvic health [ 8 ]. Correspondingly, this paper shares some generic content with the above framework publications.…”

“…This form of USI (point of care ultrasound; PoCUS) [ 5 , 6 ] has advantages of portability, few contraindications or risks and immediate clinical data. Its adoption into a variety of healthcare specialities is now widespread including respiratory medicine [ 7 ], pelvic health clinics [ 8 ] and the musculoskeletal specialism [ 9 ].…”

A proposed framework for point of care lung ultrasound by respiratory physiotherapists: scope of practice, education and governance

“…Figure 1 provides a visual representation of the framework approach. At the time of writing, the PoCUS framework approach is being applied in a range of other areas of clinical practice; as such this manuscript shares some generic content with the publication Smith et al [17].…”

Role extension in advanced ultrasound practice: A framework approach and case study

“…14 It was originally developed by one of the authors to support point of care ultrasound (PoCUS) across areas as diverse as lung ultrasound 14 and pelvic floor ultrasound. 15 This has been adapted to support novel role development in sonography.…”

“… 14 It was originally developed by one of the authors to support point of care ultrasound (PoCUS) across areas as diverse as lung ultrasound 14 and pelvic floor ultrasound. 15 This has been adapted to support novel role development in sonography. Figure 1 provides a visual representation of the framework approach, with definition and explanation of the terms summarised in Table 1 .…”