scholarly journals The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anelah McGinness ◽  
Margaret Lin-Martore ◽  
Newton Addo ◽  
Ashkon Shaahinfar
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Perceived Usefulness ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Unmet Demand

Abstract Background Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings. Methods In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results Response rate was 20% (98/485). Compared to attendings (n = 73), residents (n = 25) endorsed more exposure to POCUS in medical school (32% vs 5%, p = 0.003) and residency (12% vs 5%, p = 0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Although the majority of respondents were not POCUS users, our results could guide future efforts to study the role of POCUS in general pediatrics and develop pediatric curricula.

scholarly journals The Unmet Demand for Point-of-Care Ultrasound Among General Pediatricians: A Needs Assessment

2021 ◽  
Author(s):  
Anelah McGinness ◽  
Margaret Lin-Martore ◽  
Newton Addo ◽  
Ashkon Shaahinar
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Perceived Usefulness ◽  
Point Of Care Ultrasound ◽  
Pediatric Residents ◽  
Unmet Demand ◽  
Chi Squared ◽  
Diagnostic Applications

Abstract Background: Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal needs assessments of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings.Methods: In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results: Response rate was 20% (98/485). Compared to attendings (n=73), residents (n=25) endorsed more exposure to POCUS in medical school (32% vs 5%, p=0.003) and residency (12% vs 5%, p=0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions: There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Our results could guide design of ultrasound curricula for general pediatricians.

scholarly journals Burnout and Compassion Satisfaction: Survey Findings of Healthcare Employee Wellness During COVID-19 Pandemic using ProQOL

2021 ◽  
Vol 14 ◽  
pp. 121-127
Author(s):  
Meagan Dwyer ◽  
Marcus Alt ◽  
Joanna Brooks ◽  
Hannah Katz ◽  
Albert Poje
Keyword(s):  
Compassion Fatigue ◽  
Online Survey ◽  
Medical Center ◽  
Academic Medical Center ◽  
Compassion Satisfaction ◽  
Healthcare Systems ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Healthcare Employees

Introduction. Healthcare systems are being bombarded during the COVID-19 pandemic. Understanding burnout, compassion fatigue, and potential protective factors, such as compassion satisfaction, will be important in supporting the vital healthcare workforce. The goal of the current study was to understand the key factors of burnout, compassion fatigue, and compassion satisfaction among healthcare employees during the pandemic within the U.S. in April 2020. Methods. The authors conducted a single-center, cross-sectional online survey using the Professional Quality of Life (ProQOL) Questionnaire and three open-ended questions around stress and responses to stress during COVID-19 at a large Midwestern academic medical center with nearly 16,000 employees.    Results. Healthcare employees (613) representing over 25 professions or roles and 30 different departments within the health system were surveyed. Participants reported low levels of compassion fatigue and burnout, but moderate levels of compassion satisfaction. Compassion satisfaction was notably higher than prior literature. Key areas of stress outside of work included family, finances and housing, childcare and homeschooling, and personal health.  Conclusions. This was a cross-sectional survey, limiting causal analyses. Also, based on the qualitative responses, the ProQOL was somewhat insufficient in assessing the breadth of stressors, particularly outside of work, that healthcare employees faced due to the pandemic. Although compassion satisfaction was elevated during the initial phases of the pandemic, providing some possible protection against burnout, this may change as COVID-19 continues to surge. Healthcare systems are encouraged to assess and address the broad range of work and non-work-related stressors to best serve their vital workforce.

Accessibility and Openness to Diabetes Management Support via Mobile Phones: A Survey of People with Type 1 Diabetes Using Advanced Diabetes Technologies (Preprint)

2022 ◽  
Author(s):  
Yu Kuei Lin ◽  
Caroline Richardson ◽  
Iulia Dobrin ◽  
Rodica Pop-Busui ◽  
Gretchen Piatt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Interactive Voice Response ◽  
Medical Center ◽  
Academic Medical Center ◽  
Text Messages ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND Little is known about the feasibility of mobile health (mHealth) support among people with type 1 diabetes (T1D) using advanced diabetes technologies including continuous glucose monitors (CGMs) and hybrid closed-loop insulin pumps (HCLs). OBJECTIVE To evaluate patient access and openness to receiving mHealth diabetes support in people with T1D using CGMs/HCLs. METHODS We conducted a cross-sectional survey among T1D patients using CGMs or HCLs managed in an academic medical center. Participants reported information regarding their mobile device usage, cellular call/text message/internet connectivity, and openness to various channels of mHealth communication (smartphone applications or “apps”, text messages, and interactive voice response calls or IVR calls). Participants’ demographic characteristics and CGM data were collected from medical records. Analyses focused on differences in openness to mHealth and mHealth communication channels across groups defined by demographic variables and measures of glycemic control. RESULTS Among all participants (n=310; 64% female; mean age: 45 (SD:16)), 98% reported active cellphone use, and 80% were receptive to receiving mHealth support to improve glucose control. Among participants receptive to mHealth support, 98% were willing to share CGM glucose data for mHealth diabetes self-care assistance. Most (71%) were open to receiving messages via apps, 56% were open to text messages, and 12% were open to IVR calls. Older participants were more likely to prefer text messages (P=0.009) and IVR (P=0.03) than younger participants. CONCLUSIONS Most people with T1D who use advanced diabetes technologies have access to cell phones and are receptive to receiving mHealth support to improve diabetes control. CLINICALTRIAL Not applicable

scholarly journals P005: Regional anesthesia in Canadian emergency departments: Emergency physician practices and impressions

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S66-S66
Author(s):  
D. Wiercigroch ◽  
S. Friedman ◽  
D. Porplycia ◽  
M. Ben-Yakov
Keyword(s):  
Regional Anesthesia ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physician Practices ◽  
Canadian Association ◽  
Modifiable Factors ◽  
Barriers To Use

Introduction: The use of regional anesthesia (RA) by emergency physicians (EPs) is expanding in frequency and range of application as expertise in point-of-care ultrasound (POCUS) grows, but widespread use remains limited. We sought to characterize the use of RA by Canadian EPs, including practices, perspectives and barriers to use in the ED. Methods: A cross-sectional survey of Canadian EPs was administered to members of the Canadian Association of Emergency Physicians (CAEP), consisting of sixteen multiple choice and numerical responses. Responses were summarized descriptively as percentages and as the median and inter quartile range (IQR) for quantitative variables. Results: The survey was completed by 149/1144 staff EPs, with a response rate of 13%. EPs used RA a median of 2 (IQR 0-4) times in the past ten shifts. The most broadly used applications were soft tissue repair (84.5% of EPs, n = 126), fracture pain management (79.2%, n = 118) and orthopedic reduction (72.5%, n = 108). EPs agreed that RA is safe to use in the ED (98.7%) and were interested in using it more frequently (78.5%). Almost all (98.0%) respondents had POCUS available, however less than half (49.0%) felt comfortable using it for RA. EPs indicated that they required more training (76.5%), a departmental protocol (47.0%), and nursing assistance (30.2%) to increase their use. Conclusion: Canadian EPs engage in limited use of RA but express an interest in expanding their use. While equipment is available, additional training, protocols, and increased support from nursing staff are modifiable factors that could facilitate uptake of RA in the ED.

Prehospital ultrasound use among Canadian aeromedical service providers – A cross-sectional survey

CJEM ◽  
2019 ◽  
Vol 22 (3) ◽  
pp. 338-341
Author(s):  
Anna Sedlakova ◽  
Paul Olszynski ◽  
Philip Davis ◽  
John Froh
Keyword(s):  
British Columbia ◽  
Prince Edward Island ◽  
Service Providers ◽  
Point Of Care ◽  
Yukon Territory ◽  
Free Fluid ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Disposition

ABSTRACTObjectivesEvidence suggests that prehospital point of care ultrasound (POCUS) may change patient management. It serves as an aid in triage, physical examination, diagnosis, and patient disposition. The rate of adoption of POCUS among aeromedical services throughout Canada is unknown. The objective of this study was to describe current POCUS use among Canadian aeromedical services providers.MethodsThis is a cross-sectional observational study. A survey was emailed to directors of government-funded aeromedical services bases in Canada. Data were analyzed using descriptive statistics.ResultsThe response rate was 82.3% (14/17 aeromedical services directors), representing 41 of 46 individual bases. POCUS is used by aeromedical services in British Columbia, Alberta, Saskatchewan, and Manitoba. New Brunswick, Nova Scotia, Prince Edward Island, and Yukon reported they are planning to introduce POCUS within the next year. Ontario and Newfoundland reported they are not using POCUS and are not planning to introduce it. British Columbia is the only province currently using POCUS on fixed-wing aircraft. Most commonly reported frequency of POCUS use on missions was <25%. Most useful applications are assessment for pneumothorax, abdominal free fluid, and cardiac standstill. The most common barrier to POCUS use is cost of training and maintenance of competence.ConclusionsPrehospital POCUS is available in Western Canada with one third of the Canadian population having access to aeromedical services using ultrasound. The Maritimes and the Yukon Territory will further extend POCUS use on fixed-wing aircraft. While there are barriers to POCUS use, those bases that have adopted POCUS consider it valuable.

scholarly journals A majority of rural emergency departments in the province of Quebec use point-of-care ultrasound: a cross-sectional survey

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Pierre Léger ◽  
Richard Fleet ◽  
Julie Maltais- Giguère ◽  
Jeff Plant ◽  
Éric Piette ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals A Qualitative Identification of Gaps in Understanding About Brain Death Among Trainees, Health Care Personnel and Families at an Academic Medical Center

2020 ◽  
Vol 10 (4) ◽  
pp. 266-271
Author(s):  
Patrick M. Chen ◽  
Jamie Nicole LaBuzetta
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Brain Death ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Care Personnel ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Families

Background and Purpose: Death by whole brain criteria (brain death) is a clinical diagnosis. We sought to identify aspects of brain death that were unclear to both health care personnel and patient families. Methods: Institutional review board approved cross-sectional survey study of attendings, medical trainees (residents and fellows), senior medical students, advanced practice providers (APPs), and critical care nursing (registered nurses [RNs]) at a tertiary referral center over 6 months (March 2018 to September 2018). Surveys were completed on paper or electronically. Participants supplied the top 3 of (1) their own personal questions regarding brain death and (2) questions received from patient families about brain death from a prepared list of questions. Results: Two hundred twenty-nine individuals participated in the survey, with a response rate of 46%. Participation rates in brain death declaration among attendings (92%), RNs (84%), APPs (100%), and trainees of which included fellows (92%) and residents (85%) were high. Most frequently asked questions by trainees and health care personnel were “What are brain death mimics?” and “What is the gold standard testing?”. Questions received from patient families most commonly include “What is brain death?” and “Is brain death reversible?”. All medical students had questions about brain death. Greater than 75% of attendings endorsed having questions regarding brain death. Conclusion: Many health care personnel are involved with brain death declaration, but there are gaps in their understanding about fundamentals regarding brain death. We identify a need for early and targeted brain death education regarding brain death and family communication for various members of the health care profession.

scholarly journals MP003: AP or IP? Introduction of a new assessment of performance tool for point of care ultrasound

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S67-S67
Author(s):  
P.R. Atkinson ◽  
D. Lewis ◽  
J. Fraser
Keyword(s):  
Emergency Medicine ◽  
Point Of Care ◽  
Position Statement ◽  
Point Of Care Ultrasound ◽  
Entire Body ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Assessment Of Performance ◽  
Canadian Association ◽  
Assessment Of Practice

Introduction: Organizations including CAEP, CEUS, the International Federation for Emergency Medicine (IFEM) and the Canadian Association of Radiologists have all called for defined competency assessments for point of care ultrasound (PoCUS). Definitions of core indications vary. The requirement for ongoing assessment of performance and skills maintenance is often overlooked. We describe the introduction an IFEM approved Assessment of Practice (AP) tool across a PoCUS training program and for continued assessment. Methods: We completed a cross sectional survey and cohort study including the entire body of emergency medicine physicians at a tertiary hospital. Over a 3 year period, all practitioners were assessed for CAEP position statement defined core applications at baseline and again after 2 years using a published PoCUS AP tool. We describe the tool, its application and the performance assessment findings. Emergency physicians (EP) underwent AP following formal training including an approved course and a logbook documenting a variable number of scans. Results: 23 EPs completed training and underwent AP initially, with all 23 EPs completing further assessment within 3 years. Assessment of practice was completed for 1. Focused Diagnostic Ultrasound Assessment for AAA, eFAST, cardiac, early pregnancy; and 2. Focused Procedural Ultrasound Guidance for venous catheterization. All EPs demonstrated initial and continuing competency in these PoCUS modalities. Conclusion: The IFEM PoCUS curriculum promotes ongoing local assessment of performance. We successfully implemented this competency based approach and demonstrated feasibility, flexibility and utility in a Canadian emergency medicine program.

Breast Imaging and Image-guided Intervention in Tanzania: Initial Experience

2020 ◽  
Vol 2 (3) ◽  
pp. 269-274
Author(s):  
Roselyne Okello ◽  
Timothy B Rooney ◽  
Mwajuma Jumbe ◽  
Lulu Sakafu ◽  
Troy Koch ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Breast Cancer Incidence ◽  
Breast Disease ◽  
Point Of Care Ultrasound ◽  
Sustainable Improvement ◽  
Image Guided Intervention ◽  
Clinical Breast

Abstract Breast imaging capacity in Tanzania is currently very limited. In a country of almost 60 million people, mammographic units are exceedingly rare. The few existing units are compromised by lack of maintenance and quality control and extremely limited technologist training. Breast cancer incidence continues to increase in East Africa, while the ability to accurately diagnose and differentiate benign and malignant breast disease remains a challenge. However, as ultrasound technology improves and becomes more affordable, there is increased access to devices including hand-held point of care ultrasound. Additionally, there has been a recent expansion in the training of academic radiologists in Tanzania, creating an opportunity for possible sustainable improvement of breast imaging and intervention. Our initial efforts at the Muhimbili Academic Medical Center (MAMC) included social media advertising for symptomatic and asymptomatic women, followed by screening (clinical breast exam) and subsequent ultrasound imaging of symptomatic women. We then initiated a workflow for ultrasound-guided breast intervention, performed biopsies, reviewed results by local pathologists, and brought the postbiopsy patients back for radiologic–pathologic correlation, wound assessment, and coordination of follow-up and treatment.

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