Patron: HRH The Princess Royal 7-9 Breams BuildingsTel +44 (0)207 404 1999 London Fax +44 (0)207 067 1267 EC4A 1DT
Background In Japan, the nurse practitioner (NP) system has only been in place for a short time, and there is no ultrasound (US) simulation course for NPs. Therefore, NPs may have to attend US simulation courses for physicians. We evaluated whether US simulation course for physicians lead to improved image acquisition and interpretation amongst NPs and, if so, if these changes would be maintained over time. Methods A 2-day point-of-care ultrasound (POCUS) course designed for physicians in cardiac US, lung US, lower extremity deep vein thrombosis (DVT) US, and abdominal US was held for Japanese nurse practitioners (JNP) and JNP trainees in 2018 and 2019. Participants kept a record of the number of US examinations they performed for 3 months before and 3 months after the course. The number of US exams performed was grouped into six categories. All participants underwent pre-course, immediate post-course, and 4-month post-course testing to assess image interpretation skills, image acquisition skills, and confidence. Results Thirty-three participants from 21 facilities completed the program. Before and immediately after the course, test scores of the image interpretation test, image acquisition test, and confidence increased significantly (37.1, 72.6: P < 0.001), (13.7, 53.6: P < 0.001), and (15.8, 35.7: P < 0.001), respectively. Comparing the follow-up tests immediately after the course and 4 months later, there was no decrease in scores on the image interpretation test, the image acquisition test, or confidence (72.6, 71.8: P = 1.00) (53.6, 52.9: p = 1.00) (35.7, 33.0: P = 0.34). There was a statistically significant increase (P < 0.001) in both the total number of ultrasound examinations and in the number of ultrasound examinations by category (cardiac, lung, lower extremity DVT, and abdominal) in the 3 months before and 3 months after the course. Conclusions The POCUS simulation course for physicians is useful for JNPs to acquire US examination skills even if it is not arranged for JNPs. Image interpretation skill, image acquisition skill, and confidence improved significantly and were maintained even after 4 months of the course. It leads to behavioral changes such as increasing the number of US examinations in daily practice after the course.
No systematic methods exist for triaging outpatients with serious conditions. Our previous pilot study showed that the National Early Warning Score (NEWS) could predict admissions and unexpected intensive care unit (ICU) transfers in rapid response system-activated outpatients. The Visensia Score Index (VSI) is another artificial intelligence-based Early Warning Score Systems that automatically collates and analyzes data from bedside monitors. This single-center retrospective cohort study aimed to investigate and compare efficacy of NEWS and VSI as a prediction tool among whole first-visit patients of our internal medicine clinic. From June 1, 2018 to November 30, 2018 at a 350-bed teaching community hospital in Japan. Patient age and sex, and physiological measurements, NEWS, VSI as well as disposition and outcomes were collected. This study included 3301 patients. There were 108 (3.3%), 16 (0.5%), and 5 (0.2%) patients admitted to the general ward, high dependency unit (HDU), and ICU, respectively. The areas under the curve (AUCs) of the NEWS for hospital admission, HDU or ICU admission, and ICU admission were 0.71 (95% CI, 0.66–0.76), 0.88 (95% CI, 0.80–0.97), and 1.00 (95% CI, 0.996–1.0), respectively. The AUCs of the VSI for admission, HDU or ICU admission, and ICU admission were 0.66 (95% CI, 0.60–0.71), 0.82 (95% CI, 0.71–0.93), and 0.97 (95% CI, 0.96–0.98), respectively. The AUC of the NEWS was significantly superior to that of the VSI for hospital (p = 0.03) and ICU admission (p < 0.01). The NEWS could triage patients with serious conditions in an outpatient setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.