TY - JOUR
T1 - Effects of nurse delivered thoracic ultrasound on management of adult intensive care unit patients
T2 - A prospective observational study
AU - Smits, Thomas
AU - Heldeweg, Micah
AU - Tulleken, Amy Morreale
AU - Verlaan, Brian
AU - Floor, Lonneke
AU - Eijsenga, Alwin
AU - Lust, Erik
AU - Gelissen, Harry
AU - Girbes, Armand
AU - Elbers, Paul
AU - Tuinman, Pieter Roel
N1 - Funding Information: Eduard Bootsma, Emilia Chrustek, Anne van Wijk, Martijn Jongkind and Soyaan Mire (UltraNurses participating in data collection) and Marieke Lijnsvelt (Charge nurse of the department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc for facilitating this study) Publisher Copyright: © 2023
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Thoracic ultrasound is a valuable tool that helps diagnose cardiopulmonary disorders and guide management in intensive care unit patients. Intensive care unit nurses were trained to perform thoracic ultrasound examinations, after which they were named ‘UltraNurses’ for clinical recognizability. UltraNurses demonstrated rapid learning trajectories, but the impact on clinical-decision making remained unknown. The aim of this study was to investigate the effects of UltraNurse ultrasound on clinical management. Methods: This was a prospective observational single center study within a mixed medical and surgical intensive care unit. All adult patients with an indication for UltraNurse thoracic ultrasound were included. The study consisted of three steps: pre- and post- data collection, with the ultrasound examination conducted in-between these two steps. The examination consisted of a standardized ultrasound protocol aimed at the lungs and cardiac output. Primary outcome was what percentage of ultrasounds led to a change of management. Secondary outcomes included: percentage of changes executed within first 8 hours, frequency of pathology found, percentage of diagnosis change, and frequency of UltraNurse ultrasounds per shift. Results: A total of 102 ultrasound examinations were performed in 65 patients (89% mechanically-ventilated). Ultrasound examinations suggested changes of management in 26% of cases, of which 96% were executed within 8 hours. Most changes were within the nursing scope (56%), specifically: 44% of examinations changed fluid management. UltraNurse ultrasound detected pathology in 97% of cases. In 7% of cases, the diagnosis was changed, sometimes leading to life-saving interventions. UltraNurses performed one thoracic ultrasound examination per four shifts. Conclusion: In adult intensive care unit patients, UltraNurse thoracic ultrasound led to a change of management in more than a quarter of the cases, of which almost all were executed within the first 8 hours. Study registration: Netherlands Trial Registration NL9047, VUmc 2020.011
AB - Background: Thoracic ultrasound is a valuable tool that helps diagnose cardiopulmonary disorders and guide management in intensive care unit patients. Intensive care unit nurses were trained to perform thoracic ultrasound examinations, after which they were named ‘UltraNurses’ for clinical recognizability. UltraNurses demonstrated rapid learning trajectories, but the impact on clinical-decision making remained unknown. The aim of this study was to investigate the effects of UltraNurse ultrasound on clinical management. Methods: This was a prospective observational single center study within a mixed medical and surgical intensive care unit. All adult patients with an indication for UltraNurse thoracic ultrasound were included. The study consisted of three steps: pre- and post- data collection, with the ultrasound examination conducted in-between these two steps. The examination consisted of a standardized ultrasound protocol aimed at the lungs and cardiac output. Primary outcome was what percentage of ultrasounds led to a change of management. Secondary outcomes included: percentage of changes executed within first 8 hours, frequency of pathology found, percentage of diagnosis change, and frequency of UltraNurse ultrasounds per shift. Results: A total of 102 ultrasound examinations were performed in 65 patients (89% mechanically-ventilated). Ultrasound examinations suggested changes of management in 26% of cases, of which 96% were executed within 8 hours. Most changes were within the nursing scope (56%), specifically: 44% of examinations changed fluid management. UltraNurse ultrasound detected pathology in 97% of cases. In 7% of cases, the diagnosis was changed, sometimes leading to life-saving interventions. UltraNurses performed one thoracic ultrasound examination per four shifts. Conclusion: In adult intensive care unit patients, UltraNurse thoracic ultrasound led to a change of management in more than a quarter of the cases, of which almost all were executed within the first 8 hours. Study registration: Netherlands Trial Registration NL9047, VUmc 2020.011
KW - Cardiac output
KW - Critical care nursing
KW - Heart
KW - Lung
KW - Observational study
KW - Therapeutics
KW - Thorax
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=85160643364&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijnsa.2023.100135
DO - https://doi.org/10.1016/j.ijnsa.2023.100135
M3 - Article
SN - 2666-142X
VL - 5
JO - International Journal of Nursing Studies Advances
JF - International Journal of Nursing Studies Advances
M1 - 100135
ER -