Availability and use of antenatal point‐of‐care ultrasound services within rural South Australian health care

2021 ◽  
Author(s):  
Mikaela Doig ◽  
Amber Bidner ◽  
Janine Dizon ◽  
Katherine Guerrero ◽  
Eva Bezak ◽  
...  
Keyword(s):  
Health Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Rural South ◽  
Australian Health

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.

scholarly journals Nurses as Stakeholders in the Adoption of Mobile Technology in Australian Health Care Environments: Interview Study

JMIR Nursing ◽  
10.2196/14279 ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. e14279 ◽  
Author(s):  
Carey Mather ◽  
Elizabeth Cummings ◽  
Fred Gale
Keyword(s):  
Health Care ◽  
Mobile Technology ◽  
Digital Technology ◽  
Point Of Care ◽  
Digital Health ◽  
Health Agency ◽  
Contributing Factors ◽  
Record System ◽  
Underlying Assumption ◽  
Australian Health

Background The 2017 Australian Digital Health Agency (ADHA) Strategy is based on the underlying assumption that digital technology in health care environments is ubiquitous. The ADHA Strategy views health professionals, especially nurses, as grappling with the complexity of installing and using digital technologies to facilitate personalized and sustainable person-centered care. Yet, ironically, the 2018 debate over how to enroll Australians into the national electronic health record system and its alteration from an opt-in to an opt-out model heightened public and professional concern over what constituted a “safe, seamless and secure” health information system. What can be termed a digital technology paradox has emerged where, although it is widely acknowledged that there are benefits from deploying and using digital technology in the workplace, the perception of risk renders it unavailable or inaccessible at point of care. The inability of nurses to legitimately access and use mobile technology is impeding the diffusion of digital technology in Australian health care environments and undermining the 2017 ADHA Strategy. Objective This study explored the nature and scope of usability of mobile technology at point of care, in order to understand how current governance structures impacted on access and use of digital technology from an organizational perspective. Methods Individual semistructured interviews were conducted with 6 representatives from professional nursing organizations. A total of 10 interview questions focused on factors that impacted the use of mobile technology for learning at point of care. Seven national organizations and 52 members from the Coalition of National Nursing and Midwifery Organisations were invited to participate. Interviews were recorded and transcribed verbatim. Data analysis was systematic and organized, consisting of trial coding; member checking was undertaken to ensure rigor. A codebook was developed to provide a framework for analysis to identify the themes latent in the transcribed data. Nurses as stakeholders emerged as a key theme. Results Out of 6 participants, 4 female (67%) and 2 male (33%) senior members of the nursing profession were interviewed. Each interview lasted between 17 and 54 minutes, which reflected the knowledge of participants regarding the topic of interest and their availability. Two subthemes, coded as ways of thinking and ways of acting, emerged from the open codes. Participants provided examples of the factors that impacted the capacity of nurses to adopt digital technology from an emic perspective. There were contributing factors that related to actions, including work-arounds, attentiveness, and experiences. Nurses also indicated that there were attitudes and influences that impacted thinking regarding access and use of mobile technology at point of care. Conclusions Nurses are inadequately prepared for the digital future that has now arrived in health care environments. Nurses do not perceive that they are leaders in decision making regarding digital technology adoption, nor are they able to facilitate digital literacy or model digital professionalism.

scholarly journals P041: Point-of-care ultrasound utilization and monetary outcomes (POCUMON) study

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S79-S79
Author(s):  
D. Rusiecki ◽  
S. Douglas ◽  
C. Bell
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Point Of Care ◽  
Cost Savings ◽  
Flank Pain ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Imaging Studies ◽  
Patient Assessments ◽  
Care Costs

Introduction: Point-of-care ultrasound (POCUS) is an integral tool in the modern emergency physician's toolkit. Evidence suggests many imaging and lab investigations are ordered without true medical indications; it is unknown how POCUS utilization impacts health care costs at a patient level. The purpose of this study was to assess whether POCUS use in the emergency department (ED) was associated with cost savings via decreased laboratory and radiographic testing. Methods: POCUMON is a single-center, prospective pilot study. The participants were a convenience sample of ED staff physicians and PGY-5 Emergency Medicine (EM) residents working in the ED from July-October 2019. Physicians who used POCUS as part of their assessment had the cost of their patient investigation plans compared with those proposed by a control group of ED physicians simultaneously on-shift. The control group was blinded to the POCUS findings but had access to the patient and medical record. The lab investigations and imaging studies ordered by both groups were recorded with respective costs. Data were analyzed using a paired T-test, with sub-group analyses. Ethics approval was obtained from the Queen's University HSREB (No.6026732). Results: 50 patient assessments using POCUS were captured in the study period. 76% of patient assessments were performed by EM staff physicians; 94% of control assessments were provided by EM staff physicians. Patient chief complaints included abdominal pain (7), chest pain/dyspnea (10), flank pain (3), pregnancy concerns (4), trauma (7), extremity complaints (4), back pain (3), and other (12). The POCUS group had a trend for lower number of laboratory tests (4.7 ± 0.44 vs 5.22 ± 0.39; p = 0.28) and imaging studies (0.94 ± 0.14 vs 1.1 ± 0.11; p = 0.33). Overall health care costs were similar in both groups, with a trend to cost savings in the POCUS group ($142.00 ± 15.44 vs $174.60 ± 17.00; p = 0.12). Subgrouping identified significant cost savings in the POCUS group for patients with a chief complaint of flank pain ($43.64 vs $248.82, p = 0.01). Conclusion: POCUS use was not associated with significant health care cost savings. ED POCUS usage did see a trend towards decreased laboratory and imaging investigations. Patients presenting with flank pain had significantly lower expenditures associated with their visit when POCUS was incorporated into their assessment. Large scale prospective studies are needed to investigate if POCUS is associated with cost-savings in ED patients.

scholarly journals Better Medical Education and Health Care Through Point-of-Care Ultrasound

2012 ◽  
Vol 87 (2) ◽  
pp. 134 ◽  
Author(s):  
Richard Hoppmann ◽  
Michael Blaivas ◽  
Mahmoud Elbarbary
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Education And Health

scholarly journals Nurses as Stakeholders in the Adoption of Mobile Technology in Australian Health Care Environments: Interview Study (Preprint)

2019 ◽  
Author(s):  
Carey Mather ◽  
Elizabeth Cummings ◽  
Fred Gale
Keyword(s):  
Health Care ◽  
Mobile Technology ◽  
Digital Technology ◽  
Point Of Care ◽  
Digital Health ◽  
Health Agency ◽  
Contributing Factors ◽  
Record System ◽  
Underlying Assumption ◽  
Australian Health

BACKGROUND The 2017 Australian Digital Health Agency (ADHA) Strategy is based on the underlying assumption that digital technology in health care environments is ubiquitous. The ADHA Strategy views health professionals, especially nurses, as grappling with the complexity of installing and using digital technologies to facilitate personalized and sustainable person-centered care. Yet, ironically, the 2018 debate over how to enroll Australians into the national electronic health record system and its alteration from an opt-in to an opt-out model heightened public and professional concern over what constituted a “safe, seamless and secure” health information system. What can be termed a digital technology paradox has emerged where, although it is widely acknowledged that there are benefits from deploying and using digital technology in the workplace, the perception of risk renders it unavailable or inaccessible at point of care. The inability of nurses to legitimately access and use mobile technology is impeding the diffusion of digital technology in Australian health care environments and undermining the 2017 ADHA Strategy. OBJECTIVE This study explored the nature and scope of usability of mobile technology at point of care, in order to understand how current governance structures impacted on access and use of digital technology from an organizational perspective. METHODS Individual semistructured interviews were conducted with 6 representatives from professional nursing organizations. A total of 10 interview questions focused on factors that impacted the use of mobile technology for learning at point of care. Seven national organizations and 52 members from the Coalition of National Nursing and Midwifery Organisations were invited to participate. Interviews were recorded and transcribed verbatim. Data analysis was systematic and organized, consisting of trial coding; member checking was undertaken to ensure rigor. A codebook was developed to provide a framework for analysis to identify the themes latent in the transcribed data. Nurses as stakeholders emerged as a key theme. RESULTS Out of 6 participants, 4 female (67%) and 2 male (33%) senior members of the nursing profession were interviewed. Each interview lasted between 17 and 54 minutes, which reflected the knowledge of participants regarding the topic of interest and their availability. Two subthemes, coded as ways of thinking and ways of acting, emerged from the open codes. Participants provided examples of the factors that impacted the capacity of nurses to adopt digital technology from an emic perspective. There were contributing factors that related to actions, including work-arounds, attentiveness, and experiences. Nurses also indicated that there were attitudes and influences that impacted thinking regarding access and use of mobile technology at point of care. CONCLUSIONS Nurses are inadequately prepared for the digital future that has now arrived in health care environments. Nurses do not perceive that they are leaders in decision making regarding digital technology adoption, nor are they able to facilitate digital literacy or model digital professionalism.

scholarly journals An overview of the first year Undergraduate Medical Students Feedback on the Point of Care Ultrasound Curriculum

2018 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care Providers ◽  
Point Of Care ◽  
First Year ◽  
Clinical Anatomy ◽  
Point Of Care Ultrasound ◽  
Care Providers ◽  
Undergraduate Medical Students ◽  
Portable Ultrasound

With the technological progress of different types of portable Ultrasound machines, there is a growing demand by all health care providers to perform bedside Ultrasonography, also known as Point of Care Ultrasound (POCUS). This technique is becoming extremely useful as part of the Clinical Skills/Anatomy teaching in the undergraduate Medical School Curriculum. Teaching/training health care providers how to use these portable Ultrasound machines can complement their physical examination findings and help in a more accurate diagnosis, which leads to a faster and better improvement in patient outcomes. In addition, using portable Ultrasound machines can add more safety measurements to every therapeutic/diagnostic procedure when it is done under an Ultrasound guide. It is also considered as an extra tool in teaching Clinical Anatomy to Medical students. Using an Ultrasound is one of the different imaging modalities that health care providers depend on to reach their diagnosis, while also being the least invasive method. We thought investing in training the undergraduate Medical students on the basic Ultrasound scanning skills as part of their first year curriculum will help build up the foundation for their future career

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