Transvaginal sonography: Sonographer reflections on patient experience using a critical incident technique

Abstract

Introduction: It is important to understand patient experiences of transvaginal sonography (TVS) due to its intimate nature and potential for patient discomfort. This may place the sonographer at increased risk of complaints and litigation due to misunderstandings and unfulfilled patient expectations.Methods: The critical incident technique was used to elicit the personal experiences of sonographers performing TVS to provide perspectives of sonographer practices and their perceptions of patient experiences. Nine sonographers were asked to recall up to two positive and two negative critical incidents relating to the procedure and patient interaction during TVS. Data were analysed using staged thematic analysis.Results: Nine distinct themes emerged from the analysis; patient comfort, chaperones and companions, sonographer gender, patient privacy, language and culture, communication, patient empowerment, sonographer advocacy for the patient, and previous experiences or preconceptions. Each theme was reported in context of current relevant Australian guidelines.Discussion: Guidelines are helpful to guide the practice of TVS but do not comprehensively cover all issues raised by the sonographer participants in their goal to effect positive experiences for their patients. Sonographers can be further supported through education and review of existing local department procedures that relate to the practice of shared decision making, cultural competence, and anxiety reducing strategies. Funding: None Conflict of Interest: NoneSonography 4 55-62

Australian sonographers’ perceptions of patient safety in ultrasound imaging: Part two – translation into practice

“…34 Not knowing what to expect from an imaging examination can increase patient anxiety. 35 There were similar findings in our study: “I find a lot of my patients are very stressed, because they don’t know what’s going on” (PS28) and “you get someone to sign a consent form but they still don’t really understand” (PS16). However, in each instance the examination still proceeded.…”

Patient understanding of diagnostic ultrasound examinations in an Australian private radiology clinic

“…31 It is crucial that the referring doctor provides a complete explanation to allow patients appropriate time to consider what is involved, especially for more intimate examinations. 26 However, several prior studies conducted outside Australia have concluded that referring doctors are not providing adequate information to their patients due to an incomplete understanding of medical imaging and the involvement of ionising radiation. 5,13,19,20 This could result in the patient consenting to a procedure without being fully informed.…”

“…5,13,19,20 This could result in the patient consenting to a procedure without being fully informed. 11,26 Referring doctors' knowledge of ultrasound imaging, specifically the examination procedure and risks, needs to be assessed in an Australian setting to determine if patients are receiving adequate and accurate information.…”

“…[23][24][25] Obtaining valid consent is therefore paramount to adequately prepare the patient for their examination and is particularly crucial for invasive examinations such as transvaginal pelvic imaging. 26,27 Common misconceptions relating to ultrasound examinations include patients believing they would receive their results immediately at the conclusion of their ultrasound, misunderstanding the medical reason for their examination and assuming ultrasound imaging uses ionising radiation. 9,[11][12][13]15,17 In addition, oversimplification of ultrasound imaging in the media and the use of ultrasound for entertainment purposes has jeopardised the integrity of the sonography profession, thus creating unrealistic expectations of a quick and conclusive procedure.…”