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

• Published in: BMC health services research 2023-01, Vol.23 (1), p.84-84, Article 84
• Main Authors: Akanuwe, Joseph N A, Siriwardena, Aloysius Niroshan, Bidaut, Luc, Mitchell, Pauline, Bird, Paul, Lasserson, Daniel, Apenteng, Patricia, Lilford, Richard
• Format: Article
• Language: English
• Subjects: Adult; Allied Health Personnel; Beliefs, opinions and attitudes; Codes; Community health services; Community practice; Data analysis; Data collection; Diagnosis, Ultrasonic; Evaluation; Facilitators; Health care; Health services; Hospitals; Humans; Innovations; Interviews; Management; Medical personnel; Middle Aged; Patients; Point of care testing; Point of care ultrasound; Point-of-Care Systems; Prehospital care; Primary care; Qualitative Research; Social networks; Software; Systematic review; Teams; Ultrasonic imaging; Ultrasound practitioners; United Kingdom
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-023-09069-4

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. 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. 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. 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.