scholarly journals Analysis of an obstetrics point-of-care ultrasound training program for healthcare practitioners in Zanzibar, Tanzania

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Elizabeth A. Hall ◽  
Danielle Matilsky ◽  
Rachel Zang ◽  
Naomasa Hase ◽  
Ali Habibu Ali ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Training Program ◽  
Point Of Care ◽  
Course Completion ◽  
Point Of Care Ultrasound ◽  
Care Providers ◽  
Final Exam ◽  
Training Requirements ◽  
Hands On ◽  
The Impact

Abstract Background A point-of-care ultrasound education program in obstetrics was developed to train antenatal healthcare practitioners in rural Zanzibar. The study group consisted of 13 practitioners with different training backgrounds: physicians, clinical officers, and nurse/midwives. Trainees received an intensive 2-week antenatal ultrasound course consisting of lectures and hands-on practice followed by 6 months of direct supervision of hands-on scanning and bedside education in their clinical practice environments. Trainees were given a pre-course written exam, a final exam at course completion, and practical exams at 19 and 27 weeks. Trainees were expected to complete written documentation and record ultrasound images of at least 75 proctored ultrasounds. The objective of this study was prospectively to analyze the success of a longitudinal point-of-care ultrasound training program for antepartum obstetrical care providers in Zanzibar. Results During the 6-month course, trainees completed 1338 ultrasound exams (average 99 exams per trainee with a range of 42–128 and median of 109). Written exam scores improved from a mean of 33.7% (95% CI 28.6–38.8%) at pre-course assessment to 77.5% (95% CI 71–84%) at course completion (P < 0.0001). Practical exam mean scores improved from 71.2% at course midpoint (95% CI 62.3–80.1%) to 84.7% at course completion (95% Cl 78.5–90.8%) (P < 0.0005). Eight of the 13 trainees completed all training requirements including 75 proctored ultrasound exams. Conclusion Trainees improved significantly on all measures after the training program. 62% of the participants completed all requirements. This relatively low completion rate reflects the challenges of establishing ultrasound capacity in this type of setting. Further study is needed to determine trainees’ long-term retention of ultrasound skills and the impact of the program on clinical practice and health outcomes.

362: “FOCUSED POCUS”: A CONCISE POINT-OF-CARE ULTRASOUND TRAINING PROGRAM FOR CRITICAL CARE PROVIDERS

2018 ◽  
Vol 46 (1) ◽  
pp. 164-164
Author(s):  
Enyo Ablordeppey ◽  
Alicia Oberle ◽  
Anne Drewry ◽  
Brian Wessman ◽  
Adam Anderson ◽  
...  
Keyword(s):  
Critical Care ◽  
Training Program ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Care Providers

scholarly journals Randomized study of effectiveness of computerized ultrasound simulators for an introductory course for residents in Brazil

2016 ◽  
Vol 13 ◽  
pp. 16 ◽  
Author(s):  
Jack Philip Silva ◽  
Trevor Plescia ◽  
Nathan Molina ◽  
Ana Claudia de Oliveira Tonelli ◽  
Mark Langdorf ◽  
...  
Keyword(s):  
Point Of Care ◽  
Image Acquisition ◽  
Simulator Training ◽  
Point Of Care Ultrasound ◽  
Ultrasound Simulation ◽  
Live Model ◽  
Hands On ◽  
Model Training ◽  
The Impact ◽  
Experimental Group

Purpose: This study aimed to assess the impact of ultrasound simulation (SonoSim) on educational outcomes of an introductory point-of-care ultrasound course compared to hands-on training with live models alone. Methods: Fifty-three internal medicine residents without ultrasound experience were randomly assigned to control or experimental groups. They participated in an introductory point-of-care ultrasound course covering eight topics in eight sessions from June 23, 2014 until July 18, 2014. Both participated in lecture and hands-on training, but experimental group received an hour of computerized simulator training instead of a second hour of hands-on training. We assessed clinical knowledge and image acquisition with written multiple-choice and practical exams, respectively. Of the 53 enrolled, 40 participants (75.5%) completed the course and all testing. Results: For the 30-item written exam, mean score of the experimental group was 23.1±3.4 (n=21) vs. 21.8±4.8 (n=19), (P>0 .05). For the practical exam, mean score for both groups was 8.7 out of 16 (P>0 .05). Conclusion: The substitution of eight hours of ultrasound simulation training for live model scanning in a 24 hour training course did not enhance performance on written and image acquisition tests in an introductory ultrasound course for residents. This result suggests that ultrasound simulation technology used as a substitute for live model training on an hour-for-hour basis, did not improve learning outcomes. Further investigation into simulation as a total replacement for live model training will provide a clearer picture of the efficacy of ultrasound simulators in medical education.

Perceived Barriers and Facilitators to the use of Point-of-Care Ultrasound for Clinicians in Oregon

POCUS Journal ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. 20-21
Author(s):  
Camellia Dalai, MD ◽  
Renee K. Dversdal, MD
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Point Of Care ◽  
Primary Care Providers ◽  
Perceived Barriers ◽  
Survey Study ◽  
Point Of Care Ultrasound ◽  
Care Providers ◽  
Qualitative Survey ◽  
Perceptions And Attitudes

The use of Point-of-Care Ultrasound (POCUS) to provide clinical data beyond the history and physical examination is a relatively new practice for primary care providers and hospitalists. It takes many hours of dedicated ultrasound (US) training and practice to achieve POCUS proficiency; further, perceptions and attitudes of clinicians play a major role in adopting POCUS into daily clinical repertoire [1, 2]. Thus there are many possible barriers that could impede a clinician’s ability to develop the skillset to use POCUS in clinical practice. The state of Oregon encompasses vast rural and underserved areas where POCUS could be a useful resource to improve local patient care [3,4]. For this reason, a qualitative survey study was conducted to assess the perceived barriers of clinicians to the clinical incorporation of POCUS.  

scholarly journals The role of point-of-care ultrasound in the diagnosis of pericardial effusion: a single academic center retrospective study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew G. Hanson ◽  
Barry Chan
Keyword(s):  
Pericardial Effusion ◽  
Point Of Care ◽  
Physical Exam ◽  
Right Atrial ◽  
Point Of Care Ultrasound ◽  
X Ray ◽  
Average Systolic Blood Pressure ◽  
Time To Diagnosis ◽  
Clinically Significant ◽  
The Impact

Abstract Background Symptomatic pericardial effusion (PCE) presents with non-specific features and are often missed on the initial physical exam, chest X-ray (CXR), and electrocardiogram (ECG). In extreme cases, misdiagnosis can evolve into decompensated cardiac tamponade, a life-threatening obstructive shock. The purpose of this study is to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and therapeutic intervention of clinically significant PCE. Methods In a retrospective chart review, we looked at all patients between 2002 and 2018 at a major Canadian academic hospital who had a pericardiocentesis for clinically significant PCE. We extracted the rate of presenting complaints, physical exam findings, X-ray findings, ECG findings, time-to-diagnosis, and time-to-pericardiocentesis and how these were impacted by POCUS. Results The most common presenting symptom was dyspnea (64%) and the average systolic blood pressure (SBP) was 120 mmHg. 86% of people presenting had an effusion > 1 cm, and 89% were circumferential on departmental echocardiogram (ECHO) with 64% having evidence of right atrial systolic collapse and 58% with early diastolic right ventricular collapse. The average time-to-diagnosis with POCUS was 5.9 h compared to > 12 h with other imaging including departmental ECHO. Those who had the PCE identified by POCUS had an average time-to-pericardiocentesis of 28.1 h compared to > 48 h with other diagnostic modalities. Conclusion POCUS expedites the diagnosis of symptomatic PCE given its non-specific clinical findings which, in turn, may accelerate the time-to-intervention.

Current Clinical Practice in Point-of-Care Ultrasound Use in the PICUs Across Europe

2020 ◽  
Vol 21 (9) ◽  
pp. e716-e722
Author(s):  
Martien H. Humblet ◽  
Yogen Singh ◽  
Cecile Tissot ◽  
Daniele De Luca ◽  
Piet L. Leroy
Keyword(s):  
Clinical Practice ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Current Clinical Practice

Rescue from suicidal hangings

2011 ◽  
Vol 26 (S2) ◽  
pp. 1654-1654
Author(s):  
G. Williams ◽  
D. Murphy
Keyword(s):  
Training Program ◽  
Healthcare Staff ◽  
Work Shift ◽  
Actual Experience ◽  
Life Saving ◽  
Hands On ◽  
The Impact

The untimely event of suicidal hanging requires a timely, competent, and coordinated response by security and healthcare staff. A successful, life-saving response also requires special cutdown equipment (“suicide cutdown knife”) and staff that is trained in its proper use. The training is hands-on and practical, including retrieving the cutdown tool and actually doing some cutting. Because a serious hanging attempt is relatively rare, most security and healthcare staff have had almost no actual experience with a suicidal hanging. The presentation summarizes our in-depth training program, which includes follow-ups on every work shift to measure the impact of the training. The training includes our retention mnemonic, “The 5 Cs of Rescue.”

scholarly journals P025: Checking the pulse in the 21st century: inter-observer reliability of carotid pulse detection by point-of-care ultrasound

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S73-S74
Author(s):  
D. Smith ◽  
J. Chenkin ◽  
R. Simard
Keyword(s):  
Cardiac Arrest ◽  
Healthcare Provider ◽  
Point Of Care ◽  
Rank Test ◽  
Point Of Care Ultrasound ◽  
Current Standard ◽  
Observer Reliability ◽  
Pulse Palpation ◽  
Before And After ◽  
The Impact

Introduction: Detection of a pulse is crucial to decision-making in the care of patients who are in cardiac arrest, however, the current standard of manual pulse palpation is unreliable. An emerging alternative is the use of point-of-care ultrasound (POCUS) for direct assessment of the carotid pulse. The primary objective of this study is to determine the inter-observer reliability for healthcare provider interpretation of the carotid pulse by POCUS in patients who are peri-arrest or in cardiac arrest. Methods: We conducted a web-based survey of healthcare providers. Participants were shown a tutorial demonstrating POCUS detection of the carotid pulse and then asked to interpret 15 carotid pulse ultrasound clips from patients who were peri-arrest or in cardiac arrest. The primary outcome was inter-observer reliability for carotid pulse assessment. Secondary outcomes included inter-observer reliability stratified by healthcare provider role and POCUS experience, mean tutorial duration, mean pulse assessment duration, rate of pulse assessments < 10 seconds, and change in participant confidence before and after the study. Inter-observer reliability was determined by Krippendorff's α. Change in participant confidence was determined by Wilcoxon signed-rank test. Results: 68 participants completed our study, with a response rate of 75% (68/91). There was near perfect inter-observer reliability for pulse assessment amongst all study participants (α=0.874, 95% CI 0.869, 0.879). Senior residents (n = 24) and POCUS experts (n = 6) demonstrated the highest rates of inter-observer reliability, α=0.902 (95% CI 0.888, 0.914) and α=0.925 (95% CI 0.869, 0.972), respectively. All sub-groups had α greater than 0.8. Mean tutorial duration was 31 seconds (SD = 17.5) with maximum duration of 55 seconds. Mean pulse assessment duration was 7.7 seconds (SD = 5.2) with 76% of assessments completed within 10 seconds. Participant confidence before and after the study significantly increased from a median of 2 to a median of 4 on a 5-point Likert-type scale (z = 6.3, p < .001). Conclusion: Interpretation of the carotid pulse by POCUS showed near perfect inter-observer reliability for patients who were peri-arrest or in cardiac arrest. Participants required minimal training and indicated improved POCUS pulse assessment confidence after the study. Further work must be done to determine the impact of POCUS pulse assessment on the resuscitation of patients in cardiac arrest.

scholarly journals Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khushboo Qaim Ali ◽  
Sajid Bashir Soofi ◽  
Ali Shabbir Hussain ◽  
Uzair Ansari ◽  
Shaun Morris ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Training Session ◽  
Technical Skills ◽  
Neonatal Health ◽  
Point Of Care Ultrasound ◽  
Care Providers

Abstract Background Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts. Methods Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations. Results The majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10, p < 0.001. There was an average reduction of 1.3 s (β = − 1.3; 95% CI: − 1.66 to − 1.0) in time-to-interpretation with repeated simulator testing after adjusting for the covariates listed above. Conclusion We found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings. Trial registration ClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.

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