Routine Application of Lung Ultrasonography in Respiratory Care: Knowledge, Perceptions, and Barriers to Instigate

Abstract

Background Lung Ultrasound (LUS) had proved to be beneficial in detecting respiratory disorders at the bedside. Understanding the important role of Respiratory Therapists (RTs) in the critical care, we aimed to assess their knowledge, perceived relevance of LUS to clinical practice, current skill gaps, and barriers to practice. Methods A cross-sectional, nationwide survey conducted among the RTs working in the Kingdom of Saudi Arabia. The validated questionnaire included 4 sections; the demographics, knowledge and perceptions, applicability and self-reported proficiency, and barriers to the use of LUS by RTs. Results A total of 256 RTs across different regions of Saudi Arabia participated in this survey. 71.9% of them were males, and 46.1% of the participants were having <5 years of working experience. Only (18.1%) of the participants used LUS in their clinical practice, and (43%) of them had never received any training. 66% of the participants perceived LUS as an effective tool in the RT practice and immensely valuable in their daily practice (70%). A large proportion of RTs perceived LUS to be ineffective in calculating the lung score (50.4%), assessing the diaphragm (40.2%), and detecting pulmonary edema (38.3%). Calculating lung score has a lower mean score of 2.55 on both skills, and identifying its applicability to clinical practice with a mean score of 2.71 than other indications. Lack of training and curriculum (154/256; 60.2%) remains the top barrier that prevented RTs from using LUS in their clinical practice. Conclusion While many RTs in Saudi Arabia perceived LUS as an effective tool in the RT practice, considerable competence gap exist, indicating the need for LUS training. There is a need for incorporating LUS into the curriculum of RT schools and promoting competency-based training for the current RT workforce to help improve patient care.

Lung ultrasound in respiratory therapy: a global reflective survey

“…The attitude of the working professional RT regarding the need for the inclusion of LUS curriculum in RT school reflected the necessity of the same. This finding was backed by another cross-sectional study that focused on the RTs working in Saudi Arabia where the results showed the need of integrating LUS into RT curriculum [ 30 ].…”

“…It is understood that the paucity of focused training and position statements specific for the RTs to perform LUS might have led to the ambiguity as reflected in the responses of the knowledge domain. Additionally, this uncertainty in the knowledge-related domain of RTs might perpetuate considering their naiveness in LUS and the infancy of the profession in some parts of the world [ 30 ].…”

“…In our study, irrespective of diverse demographic details, half of the total respondents agreed that there might exist barriers for the RTs to practice LUS, and the other half had mixed opinions. Even though the survey did not subcategorize the types of expected barriers, the potential barriers to RTs’ involvement in LUS practice, as reflected from the literature include lack of formal training and curriculum, lack of resources and mentors, time constraints, lack of accreditation or standardization, resistance to practice, and lack of confidence [ 30 ]. Strategies to overcome these barriers include investing in equipment and resource sharing, providing integrated training sessions and hybrid self-paced programs, implementing standardized training guidelines and tailored certification programs, offering evidence-based education and inclusive approaches, and providing frequent practice opportunities and mentorship [ 37 , 39 , 40 , 43 ].…”

“…There is evidence to support the involvement of non-physician healthcare professionals such as nurses, paramedics, and physiotherapists in the practice of ultrasonography [ 51 – 53 ], and some articles reflect the need of inclusion of LUS into the scope of practice of RTs [ 17 , 28 – 30 ]. It was reiterated in these articles that considering the nature of the profession, equipping RTs with LUS knowledge will be an added value in improving the quality of patient care and patient safety.…”