Practitioners' views on community implementation of point-of-care ultrasound (POCUS) in the UK: a qualitative interview study.

Community practice Facilitators Point of care ultrasound Prehospital care Primary care Ultrasound practitioners

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
25 Jan 2023
Historique:
received: 01 07 2022
accepted: 16 01 2023
entrez: 25 1 2023
pubmed: 26 1 2023
medline: 28 1 2023
Statut: epublish

Résumé

Implementing Point-of-care ultrasound (POCUS) in community practice could help to decide upon and prioritise initial treatment, procedures and appropriate specialist referral or conveyance to hospital. A recent literature review suggests that image quality, portability and cost of ultrasound devices are all improving with widening indications for community POCUS, but evidence about community POCUS use is needed in the UK. We aimed to explore views of clinical practitioners, actively using ultrasound, on their experiences of using POCUS and potential facilitators and barriers to its wider implementation in community settings in the UK. We conducted a qualitative interview study with practitioners from community and secondary care settings actively using POCUS in practice. A convenience sample of eligible participants from different clinical specialties and settings was recruited using social media adverts, through websites of relevant research groups and snowball sampling. Individual semi-structured interviews were conducted online using Microsoft Teams. These were recorded, transcribed verbatim, and analysed using a Framework approach supported by NVivo 12. We interviewed 16 practitioners aged between 40 and 62 years from different professional backgrounds, including paramedics, emergency physicians, general practitioners, and allied health professionals. Participants identified key considerations and facilitators for wider implementation of POCUS in community settings in the UK: resource requirements for deployment and support of working devices; sufficient time and a skilled workforce; attention to training, education and support needs; ensuring proper governance, guidelines and quality assurance; workforce considerations; enabling ease of use in assisting decision making with consideration of unintended consequences; and more robust evidence to support perceptions of improved patient outcomes and experience. POCUS could be useful for improving patient journey and health outcomes in community care, but this requires further research to evaluate outcomes. The facilitators identified could help make community POCUS a reality.

Sections du résumé

BACKGROUND BACKGROUND
Implementing Point-of-care ultrasound (POCUS) in community practice could help to decide upon and prioritise initial treatment, procedures and appropriate specialist referral or conveyance to hospital. A recent literature review suggests that image quality, portability and cost of ultrasound devices are all improving with widening indications for community POCUS, but evidence about community POCUS use is needed in the UK. We aimed to explore views of clinical practitioners, actively using ultrasound, on their experiences of using POCUS and potential facilitators and barriers to its wider implementation in community settings in the UK.
METHODS METHODS
We conducted a qualitative interview study with practitioners from community and secondary care settings actively using POCUS in practice. A convenience sample of eligible participants from different clinical specialties and settings was recruited using social media adverts, through websites of relevant research groups and snowball sampling. Individual semi-structured interviews were conducted online using Microsoft Teams. These were recorded, transcribed verbatim, and analysed using a Framework approach supported by NVivo 12.
RESULTS RESULTS
We interviewed 16 practitioners aged between 40 and 62 years from different professional backgrounds, including paramedics, emergency physicians, general practitioners, and allied health professionals. Participants identified key considerations and facilitators for wider implementation of POCUS in community settings in the UK: resource requirements for deployment and support of working devices; sufficient time and a skilled workforce; attention to training, education and support needs; ensuring proper governance, guidelines and quality assurance; workforce considerations; enabling ease of use in assisting decision making with consideration of unintended consequences; and more robust evidence to support perceptions of improved patient outcomes and experience.
CONCLUSIONS CONCLUSIONS
POCUS could be useful for improving patient journey and health outcomes in community care, but this requires further research to evaluate outcomes. The facilitators identified could help make community POCUS a reality.

Identifiants

pubmed: 36698100
doi: 10.1186/s12913-023-09069-4
pii: 10.1186/s12913-023-09069-4
pmc: PMC9876652
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

84

Informations de copyright

© 2023. The Author(s).

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Auteurs

Joseph N A Akanuwe (JNA)

Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, England.

Aloysius Niroshan Siriwardena (AN)

Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, England. nsiriwardena@lincoln.ac.uk.

Luc Bidaut (L)

School of Computer Science, College of Science, University of Lincoln, Lincoln, England.

Pauline Mitchell (P)

School of Health and Social Care, University of Lincoln, Lincoln, England.

Paul Bird (P)

Institute for Translational Medicine Research & Development, University Hospitals Birmingham NHS Foundation Trust, West Midlands Academic Health Science Network, Birmingham, England.

Daniel Lasserson (D)

Warwick Medical School, University of Warwick, Coventry, England.
Department of Gerontology, Oxford University Hospitals NHS Foundation Trust, Oxford, England.

Richard Lilford (R)

Institute of Applied Health Research, University of Birmingham, Birmingham, England.

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