Point-of-care ultrasound education needs for nurse practitioners in primary care settings: An integrative review

Abstract

Point-of-care ultrasonography (POCUS) is the process of operating a compact ultrasound machine at a patient's location and immediately integrating the images generated into patient care. POCUS can help nurse practitioners (NPs) make more accurate diagnoses, facilitate safer procedures, and bridge health care access gaps in resource-limited settings such as primary care; however, it is widely agreed that POCUS is operator-dependent and that appropriate education is required to competently operate the device. This integrative review sought to determine what education NPs need to competently operate POCUS in primary care and it was found that there is no data specific to NPs; much of the available information is instead within the medical literature. Given the numerous benefits of POCUS for improving patient care and health care systems efficiency, NPs must urgently determine their POCUS education needs as they have ethical and legal obligations, in addition to a professional responsibility to ensure safe, highquality patient care.

Clinician’s Corner: An introduction to point-of-care ultrasound

“…While the literature demonstrating that RNs can safely operate POCUS continues to evolve, there are reports that nurses, physiotherapists, and respiratory therapists with appropriate training can safely operate POCUS with beneficial patient outcomes (See et al, 2016;Tulleken et al, 2019;Whittaker et al, 2007;Zisis et al, 2022). One hospital system in California has trained nurses to identify features of pulmonary edema, roughly estimate ejection fraction, and detect pathological features of cardiac physiology with POCUS (Lai & Paquin, 2020). Lastly, in a prospective observational study of fluid resuscitation among patients with sepsis, emergency RNs were found to have excellent inter-rater agreement with emergency physicians for all ultrasound scans, and these RNs were able to safely make adjustment to ongoing fluid resuscitation requirements (Selden et al, 2017).…”