Scope of point-of-care ultrasound practice in rural New Zealand
Garry Nixon 1 , Kati Blattner 1 , Jillian Muirhead 1 , Wendy Finnie 1 , Ross Lawrenson 2 , Ngaire Kerse 31 Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
2 Medical Research Centre, University of Waikato and Waikato District Health Board, New Zealand
3 School of Population Health, University of Auckland, Tamaki, Auckland, New Zealand
Correspondence to: Garry Nixon, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Email: garry.nixon@otago.ac.nz
Journal of Primary Health Care 10(3) 224-236 https://doi.org/10.1071/HC18031
Published: 28 August 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Point-of-care ultrasound (POCUS) is an increasingly common adjunct to the clinical assessment of patients in rural New Zealand.
AIM: To describe the scope of POCUS being practiced by rural generalist hospital doctors and gain insights, from their perspective, into its effect.
METHODS: This was a mixed-methods descriptive study. Main outcome measures were type and frequency of POCUS being undertaken. A questionnaire was given to POCUS-active rural hospital doctors to survey the effect of POCUS on clinical practice and assess issues of quality assurance.
RESULTS: The most commonly performed scans were: cardiac (18%) and volume scans (inferior vena cava and jugular venous pressure) (14%), followed by gallbladder (13%), kidney (11%), Focused Assessment with Sonography in Trauma (FAST) (7%), bladder (6%), leg veins (6%) and lungs (5%). There was large variation in frequency of scan types between the study hospitals that could not be accounted for by differences in training.
DISCUSSION: Rural generalists consider the broad scope of POCUS they practise to be an important but challenging skill set. Clinical governance, including an agreed scope and standards, may increase the benefits and improve the safety of rural POCUS.
KEYWORDS: Rural hospital; rural medical education; diagnostic imaging; rural health services
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