Pediatric Emergency Medicine Physicians' Use of Point-of-care Ultrasound and Barriers to Implementation: A Regional Pilot Study.

Autor: Gold DL; Department of Emergency Medicine Nationwide Children's Hospital and The Ohio State University College of Medicine Columbus OH., Marin JR; Departments of Pediatrics and Emergency Medicine Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine Pittsburgh PA., Haritos D; Department of Emergency Medicine and Pediatrics Children's Hospital of Michigan and Wayne State University School of Medicine Detroit MI., Melissa Skaugset L; Department of Emergency Medicine C. S. Mott Children's Hospital and University of Michigan School of Medicine Ann Arbor MI.; Present address: Mary Bridge Children's Hospital in Tacoma WA., Kline JM; Nationwide Children's Hospital Columbus OH., Stanley RM; Department of Emergency Medicine Nationwide Children's Hospital and The Ohio State University College of Medicine Columbus OH., Way DP; Department of Emergency Medicine The Ohio State University College of Medicine Columbus OH., Bahner DP; Department of Emergency Medicine The Ohio State University College of Medicine Columbus OH.
Jazyk: angličtina
Zdroj: AEM education and training [AEM Educ Train] 2017 Aug 29; Vol. 1 (4), pp. 325-333. Date of Electronic Publication: 2017 Aug 29 (Print Publication: 2017).
DOI: 10.1002/aet2.10049
Abstrakt: Objectives: Point-of-care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs).
Methods: An electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24-item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs. We used descriptive and inferential statistics to profile respondent's PEM POCUS experience and proficiency and Rasch analysis to evaluate barriers to implementation.
Results: Our return rate was 92.8% (128/138). Respondents were attending physicians (68%) and fellows (28%). Most completed pediatric residencies prior to PEM fellowship (83.6%). Almost all had some form of ultrasound education (113/128, 88.3%). Approximately half (46.9%) completed a formal ultrasound curriculum. More than half (53.2%) said their ultrasound education was pediatric-specific. Most participants (67%) rated their POCUS proficiency low (Levels 1-2), while rating proficiency in other professional competencies (procedures 52%, emergency stabilization 70%) high (Levels 4-5). There were statistically significant differences in POCUS proficiency between those with formal versus informal ultrasound education (p < 0.001) and those from pediatric versus emergency medicine residencies (p < 0.05). Participants identified both personal barriers discomfort with POCUS skills (76.7%), insufficient educational time to learn POCUS (65%), and negative impact of POCUS on efficiency (58.5%)-and institutional barriers to the use of ultrasound-consultants will not use ultrasound findings from the ED (60%); insufficient mentoring (64.7%), and POCUS not being a departmental priority (57%).
Conclusions: While POCUS utilization continues to grow in PEM, significant barriers to full implementation still persist. One significant barrier relates to the need for dedicated time to learn and practice POCUS to achieve sufficient levels of proficiency for use in practice.
Databáze: MEDLINE
Externí odkaz: