三级医疗机构急诊科远程超声波咨询项目的量化需求评估。

IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Internal and Emergency Medicine Pub Date : 2025-09-01 Epub Date: 2024-11-05 DOI:10.1007/s11739-024-03809-y
Onyinyechi F Eke, Kelechi Umoga, Christina Morone, Hamid Shokoohi, Andrew Liteplo, Jessica Haberer
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引用次数: 0

摘要

病床旁超声检查(POCUS)已被证明有利于促进患者护理,但急诊医学(EM)临床医生对它的采用情况却不尽相同。我们确定了一家三级医院急诊科(ED)的 POCUS 使用模式以及 POCUS 整合方面的差距。这些数据为后续开发远程超声(tele-US)会诊项目提供了一个以用户为中心的平台。我们编制了一份包含 25 个项目的需求评估调查表,并使用 5 点李克特量表来评估急诊科临床医生目前使用 POCUS 的模式以及对 POCUS 的潜在需求。我们对数据进行了描述性分析,并使用卡方分析评估临床医生在 POCUS 使用和舒适度方面的差异。总体而言,48%(91/190)符合条件的医疗服务提供者对调查做出了回应。回复的临床医生包括 38% (35/91)的主治医师(包括研究员)、29% (26/91)的住院医师和 33% (30/91)的高级医师 (APP)。在评估需求时,70%(58/83)的临床医生指出,如果他们接受过更多培训,他们会更多地使用 POCUS。76%(63/83)的临床医生对图像采集感到得心应手,68%(56/83)的临床医生对图像解读感到得心应手。与住院医师相比,APP 在 POCUS 图像解读和 POCUS 结果的临床整合方面不太熟练(分别为 χ2: 16.3、P 2: 5.1、P = 0.02)。如果在图像采集和图像解读方面可以通过远程实时监督,65%(54/83)的临床医生会更多地使用 POCUS。急诊科临床医生表示非常需要进一步的实时 POCUS 培训和指导,尤其是在图像解读方面。以临床医生为中心的策略(如远程 USB)有可能提高 POCUS 的熟练程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A quantitative needs assessment for a tele-ultrasound consult program in a tertiary care Emergency Department.

Point-of-care ultrasound (POCUS) has been shown to be beneficial in facilitating patient care, but its adoption is variable among emergency medicine (EM) clinicians. We identified the patterns of POCUS use and gaps in POCUS integration in a tertiary care emergency department (ED). These data provide a user-centered platform for subsequent development of a tele-ultrasound (tele-US) consultation program. We developed a 25-item needs assessment survey and used a 5-point Likert scale to assess current patterns of POCUS use and potential needs for POCUS among EM clinicians. Data were analyzed descriptively, and a chi-square analysis was used to assess for differences in POCUS use and comfort levels among clinicians. Overall, 48% (91/190) of eligible providers responded to the survey. Clinician responders included 38% (35/91) attendings (including fellows), 29% (26/91) residents, and 33% (30/91) advance practice providers (APPs). In assessing needs, 70% (58/83) of clinicians noted they would use POCUS more if they had more training. 76% (63/83) of clinicians felt comfortable with image acquisition and 68% (56/83) with image interpretation. APPs were less comfortable with POCUS image interpretation and clinical integration of POCUS findings compared to residents (χ2: 16.3, p < 0.0001 and χ2: 5.1, p = 0.02, respectively). 65% (54/83) of clinicians would use POCUS more if real-time supervision via tele-US was available for image acquisition and image interpretation. EM clinicians indicated a substantial need for further real-time POCUS training and supervision, especially for image interpretation. A clinician-centered strategy, such as tele-US, has potential to increase proficient use of POCUS.

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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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