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

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Abstract

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:
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:
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:
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.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Ultrasonics in medicine, Point-of-care testing, Ultrasonic equipment, Ultrasonic imaging
Journal or Publication Title: BMC Health Services Research
Publisher: BioMed Central
ISSN: 1472-6963
Official Date: 25 January 2023
Dates:
Date
Event
25 January 2023
Published
16 January 2023
Accepted
Volume: 23
Number: 1
Article Number: 84
DOI: 10.1186/s12913-023-09069-4
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons open licence)
Date of first compliant deposit: 30 January 2023
Date of first compliant Open Access: 30 January 2023
RIOXX Funder/Project Grant:
Project/Grant ID
RIOXX Funder Name
Funder ID
Applied Research Collaboration East Midlands
[NIHR] National Institute for Health Research
Applied Research Collaboration West Midlands
[NIHR] National Institute for Health Research
Community Healthcare Med Tech
[NIHR] National Institute for Health Research
IVD Cooperative
[NIHR] National Institute for Health Research
URI: https://wrap.warwick.ac.uk/173150/

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