Taylor M Douglas1, Andrea R Levine2, Peter P Olivieri3, Michael T McCurdy4, Alfred Papali3, Marc T Zubrow3, Karen M Rodick5, Julie M Hurley5, Avelino C Verceles6. 1. Department of Emergency Medicine, SUNY Downstate School of Medicine, 450 Clarkson Ave, Box 1228, Brooklyn, NY 11203, United States. 2. Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Ave, 628 NW, Pittsburgh, PA 15213, United States. 3. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St, 2nd Floor, Baltimore, MD 21201, United States. 4. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St, 2nd Floor, Baltimore, MD 21201, United States; Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca St, 6th Floor, Baltimore, MD 21201, United States. 5. Intensive Care Unit, University of Maryland Midtown Campus, 827 Linden Ave, 5th Floor, Baltimore, MD 21201, United States. 6. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St, 2nd Floor, Baltimore, MD 21201, United States; Intensive Care Unit, University of Maryland Midtown Campus, 827 Linden Ave, 5th Floor, Baltimore, MD 21201, United States. Electronic address: avercele@medicine.umaryland.edu.
Abstract
BACKGROUND: Nurses and other non-physician providers have demonstrated proficiency at obtaining images in the tele-ultrasound system. However, use of this skill requires comfort with the procedure and willingness to incorporate it into practice. OBJECTIVES: To assess 1) level of comfort of non-physician providers performing tele-ultrasound before and after brief training and 2) feasibility of implementing an educational programme that improves level of comfort. METHODS: Feasibility study including a brief training session followed by hands-on tele-ultrasound. The pilot cohort performed tele-ultrasound on a healthy volunteer. The clinical cohort performed tele-ultrasound on criticalli ill patients with shock or respiratory failure. Remote intensivists provided real-time guidance via tele-medicine technology. Each participant completed a survey assessing training experience and level of comfort before and after training. RESULTS: Sixteen non-physician providers participated. All participants agreed that the training session prepared them for image acquisition and that the training experience was positive. The number of participants comfortable with ultrasound improved significantly (before vs. after training: 5/16 [31%] vs. 16/16 [100%], mean Likert score 2.7 vs. 4.8, p = 0.001). CONCLUSIONS: After brief training, participants could comfortably perform tele-ultrasound and were more willing to incorporate it into tele-ICU-directed care. Results support conducting a larger-scale trial of tele-US to assess clinical utility.
BACKGROUND: Nurses and other non-physician providers have demonstrated proficiency at obtaining images in the tele-ultrasound system. However, use of this skill requires comfort with the procedure and willingness to incorporate it into practice. OBJECTIVES: To assess 1) level of comfort of non-physician providers performing tele-ultrasound before and after brief training and 2) feasibility of implementing an educational programme that improves level of comfort. METHODS: Feasibility study including a brief training session followed by hands-on tele-ultrasound. The pilot cohort performed tele-ultrasound on a healthy volunteer. The clinical cohort performed tele-ultrasound on criticalli ill patients with shock or respiratory failure. Remote intensivists provided real-time guidance via tele-medicine technology. Each participant completed a survey assessing training experience and level of comfort before and after training. RESULTS: Sixteen non-physician providers participated. All participants agreed that the training session prepared them for image acquisition and that the training experience was positive. The number of participants comfortable with ultrasound improved significantly (before vs. after training: 5/16 [31%] vs. 16/16 [100%], mean Likert score 2.7 vs. 4.8, p = 0.001). CONCLUSIONS: After brief training, participants could comfortably perform tele-ultrasound and were more willing to incorporate it into tele-ICU-directed care. Results support conducting a larger-scale trial of tele-US to assess clinical utility.