Highlights
- •Point-of-care ultrasound (POCUS) is a valuable tool to augment medical decision making in the emergency and critical care settings.
- •Nurse practitioners (NPs) can augment clinical decision making through formal POCUS transthoracic echocardiographic (TTE) training and credentialing.
- •NPs can be trained in the acquisition and interpretation of POCUS studies, specifically TTE, using a multifaceted training approach.
- •Hands-on training augments proficiency in POCUS TTE image acquisition.
Abstract
The objective of this initiative is to determine the efficacy of a rigorous point-of-care
ultrasonography (POCUS) training program for nurse practitioners (NPs) in the domain
of transthoracic echocardiography (TTE). Two NPs and 1 physician assistant completed
online and didactic training. Training was evaluated using multiple modalities. Assessment
scores and self-perceived competency ratings improved in all aspects of the TTE examination
after training. Hands-on supervision augmented the efficiency of training in study
acquisition. A multifaceted approach to POCUS training is effective for NPs with optimal
methodologies including didactic learning and supervised hands-on training for image
acquisition.
Keywords
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References
- Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.National Academies Press, 2009
- How have providers responded to the increased demand for health care under the Affordable Care Act?.2017
- PR newswire.
- Nurse practitioners and physician assistants in acute and critical care: a concise review of the literature and data 2008–2018.Crit Care Med. 2019; 47: 1442-1449https://doi.org/10.1097/CCM.0000000000003925
- A systematic review of the cost-effectiveness of ultrasound in emergency care settings.Ultrasound J. 2021; 13: 16https://doi.org/10.1186/s13089-021-00216-8
- Point-of-care ultrasonography.N Engl J Med. 2021; 385: 1593-1602https://doi.org/10.1056/NEJMra1916062
- A decade of progress in critical care echocardiography: a narrative review.Intensive Care Med. 2019; 45: 770-788https://doi.org/10.1007/s00134-019-05604-2
- Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients—part II: cardiac ultrasonography.Crit Care Med. 2016; 44: 1206-1227https://doi.org/10.1097/CCM.0000000000001847
- Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine.Ann Emerg Med. 2016; 69: e27-e54https://doi.org/10.1016/j.annemergmed.2016.08.457
- Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients—part I: general ultrasonography.Crit Care Med. 2015; 43: 2479-2502https://doi.org/10.1097/CCM.0000000000001216
- Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.Trop Med Int Health. 2015; 20: 1067-1072https://doi.org/10.1111/tmi.12511
- Mid-level providers demonstrate proficiency in FAST after directed training.Crit Ultrasound J. 2011; 3: 111-113https://doi.org/10.1007/s13089-011-0070-7
- Emergency department ultrasound by nurse practitioners.J Am Acad Nurse Pract. 2010; 22: 352-355https://doi.org/10.1111/j.1745-7599.2010.00518.x
- Ultrasound detection of pneumothorax with minimally trained sonographers: a preliminary study.J Spec Oper Med. 2009; 9: 43-46
- Brief report of a novel advanced practice provider-led course for ultrasound novices.J Am Assoc Nurse Pract. 2018; 30: 64-68https://doi.org/10.1097/JXX.0000000000000022
- Implementation of pulmonary ultrasound training for critical care advanced practice providers.J Am Assoc Nurse Pract. 2019; 31: 247-254https://doi.org/10.1097/jxx.0000000000000128
- Nurse delivered focused echocardiography to determine intravascular volume status in a deployed maritime critical care unit.Intensive Care Med Exp. 2015; 3: 1-2https://doi.org/10.1186/2197-425X-3-S1-A919
- 1030: an advanced practice provider-led introductory point-of-care ultrasound course’s effect on learners.Crit Care Med. 2020; 48 (494): 494https://doi.org/10.1097/01.ccm.0000643056.21334.51
- 361: point-of-care ultrasound training program for critical care medicine advanced practice providers.Crit Care Med. 2018; 46 (163): 163https://doi.org/10.1097/01.ccm.0000528380.35273.a9
- Nurse Practitioner use of point-of-care ultrasound in critical care.J Nurse Pract. 2018; 14: 383-388https://doi.org/10.1016/j.nurpra.2017.12.002
- Point of care ultrasound use by registered nurses and nurse practitioners in clinical practice: an integrative review.Collegian. 2021; 28: 456-463https://doi.org/10.1016/j.colegn.2020.10.002
- Prospective assessment of a score for assessing basic critical-care transthoracic echocardiography skills in ventilated critically ill patients.Ann Intensive Care. 2014; 4: 1-8https://doi.org/10.1186/2110-5820-4-12
- Impact of a focused transthoracic echocardiography training course for rescue applications among anesthesiology and critical care medicine practitioners: a prospective study.J Cardiothorac Vasc Anesth. 2015; 29: 576-581https://doi.org/10.1053/j.jvca.2014.10.013
- Skills acquisition for novice learners after a point-of-care ultrasound course: does clinical rank matter?.BMC Med Educ. 2018; 18: 202https://doi.org/10.1186/s12909-018-1310-3
- Advanced practice provider point-of-care ultrasound guidelines.Ann Emerg Med. 2019; 74: e89-e90https://doi.org/10.1016/j.annemergmed.2019.07.035
- Advanced practice providers proficiency-based model of ultrasound training and practice in the ED.J Am Coll Emerg Physicians Open. 2022; 3: e12645https://doi.org/10.1002/emp2.12645
- Integration of ultrasound into the physician assistant curriculum.J Physician Assist Educ. 2019; 30: 103-110https://doi.org/10.1097/jpa.0000000000000251
- Standardized adult-gerontology acute care nurse practitioner point-of-care ultrasound training: a new perspective in the age of a pandemic.J Am Assoc Nurse Pract. 2020; 32: 416-418https://doi.org/10.1097/jxx.0000000000000448
- Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine.Ann Emerg Med. 2017; 69: e27-e54https://doi.org/10.1016/j.annemergmed.2016.08.457
Ohio Nurse Practice Act, Ohio Rev Code § 4723-8-02 (2018).
Ohio Revised Code. Code § 4730.02 2006 & rev (2019).
- American College of Chest Physicians/ La Société de Réanimation de Langue Française statement on competence in critical care ultrasonography.Chest. 2009; 135: 1050-1060
- Critical Care Ultrasound.2013
- Assessment of left ventricular function by intensivists using hand-held echocardiography.Chest. 2009; 135: 1416-1420https://doi.org/10.1378/chest.08-2440
- Accuracy of emergency physician assessment of left ventricular ejection fraction and central venous pressure using echocardiography.Acad Emerg Med. 2003; 10: 973-977https://doi.org/10.1197/S1069-6563(03)00317-8
Biography
Kelly A. Rath, DNP, ACNP-BC, Jordan B. Bonomo, MD, and Kathleen Ballman, DNP, ACNP-BC, CEN, are all with the Department of Neurocritical Care, Gardner Neuroscience Institute in Cincinnati, OH. Kelly Rath can be contacted at [email protected]
Article info
Publication history
Published online: November 03, 2022
Footnotes
In compliance with standard ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.
Identification
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© 2022 Elsevier Inc. All rights reserved.
