Ruth S Burk1, Angela Parker2, Lisa Sievers3, Melissa B Rooney4, Anathea Pepperl5, Christine M Schubert6, Mary Jo Grap7. 1. School of Nursing, University of Texas, Health Science Center at Houston, 6901 Bertner Avenue, Houston, TX 77030, United States. 2. CVS Minute Clinic, Richmond, VA, United States. 3. School of Nursing, Virginia Commonwealth University, 1100 East Leigh Street, Richmond, VA 23298-0567, United States. 4. Georgia Kidney Associates, 55 Whitcher Street, Marietta, GA 30060, United States. 5. School of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA 23284-3068, United States. 6. Department of Mathematics and Statistics, Air Force Institute of Technology, 2950 Hobson Way, Wright-Patterson Air Force Base, OH 45433, United States. 7. School of Nursing, Virginia Commonwealth University, 1100 East Leigh Street, Richmond, VA 23298-0567, United States. Electronic address: mjgrap@vcu.edu.
Abstract
OBJECTIVES: High-frequency ultrasound may evaluate those at risk for pressure ulcers. Images may be obtained by clinicians with limited training. The prone position is recommended for obtaining sacral scans but may not be feasible in the critically ill. This study investigated image quality using multiple operators and a variety of patient positions. RESEARCH METHODOLOGY: Sacral scans were performed in three randomised positions in 50 volunteers by three different investigators using a 20 MHz ultrasound system. General linear models and ANOVA random effects models were used to examine the effects of operator and position on image quality rating, and measures of dermal thickness and dermal density. RESULTS: The best scan for each position and operator was used for analysis (n=447 images). Image rating varied by operator (p=0.0004), although mean ratings were 3.5 or above for all operators. Dermal thickness was less for the prone position than in 90° or 60° side-lying positions (p=0.0137, p=0.0003). Dermal density was lower for the prone position than for the 90° or 60° positions (p<0.0001 for both). CONCLUSIONS: These data show that overall scan quality was acceptable in all positions with all operators. However, differences were found between side-lying positions and the prone for dermal thickness and dermal density measures.
RCT Entities:
OBJECTIVES: High-frequency ultrasound may evaluate those at risk for pressure ulcers. Images may be obtained by clinicians with limited training. The prone position is recommended for obtaining sacral scans but may not be feasible in the critically ill. This study investigated image quality using multiple operators and a variety of patient positions. RESEARCH METHODOLOGY: Sacral scans were performed in three randomised positions in 50 volunteers by three different investigators using a 20 MHz ultrasound system. General linear models and ANOVA random effects models were used to examine the effects of operator and position on image quality rating, and measures of dermal thickness and dermal density. RESULTS: The best scan for each position and operator was used for analysis (n=447 images). Image rating varied by operator (p=0.0004), although mean ratings were 3.5 or above for all operators. Dermal thickness was less for the prone position than in 90° or 60° side-lying positions (p=0.0137, p=0.0003). Dermal density was lower for the prone position than for the 90° or 60° positions (p<0.0001 for both). CONCLUSIONS: These data show that overall scan quality was acceptable in all positions with all operators. However, differences were found between side-lying positions and the prone for dermal thickness and dermal density measures.
Authors: Mary Jo Grap; Ruth Srednicki Burk; Valentina Lucas; Cindy L Munro; Paul A Wetzel; Christine M Schubert Journal: Intensive Crit Care Nurs Date: 2014-10-16 Impact factor: 3.072
Authors: Paul R Quintavalle; Courtney H Lyder; Philip J Mertz; Connie Phillips-Jones; Mary Dyson Journal: Adv Skin Wound Care Date: 2006 Nov-Dec Impact factor: 2.347
Authors: Alison P Porter-Armstrong; Catherine Adams; Anne S Moorhead; Jeannie Donnelly; Jane Nixon; Daniel L Bader; Courtney Lyder; May D Stinson Journal: ISRN Nurs Date: 2013-02-21
Authors: Ruth S Burk; Mary Jo Grap; Valentina Lucas; Cindy L Munro; Paul A Wetzel; Christine M Schubert Journal: Adv Wound Care (New Rochelle) Date: 2017-11-01 Impact factor: 4.730