(1078) Improving Bedside Ultrasound Education and Utilization for Critical Care Advanced Practice Providers

Introduction: In the United States six million patients are admitted to a critical care (CC) unit annually. Point of care ultrasound (POCUS) has become a common diagnostic tool in assessing hemodynamic and fluid status of patients in CC units. The use of POCUS has been shown to improve the quality of care and improve the CC provider's diagnostic abilities as it identifies life threatening patient conditions. Within CC units, Advanced Practice Providers (APPs) have become critical members of the interdisciplinary team and have been found to increase patient and nurse satisfaction, decrease cost, and positively impact resident and fellow training. Despite the wide utilization of POCUS in practice, this education is not typically incorporated in the graduate APP curriculum. In an urban academic medical center, APPs staff all of the CC areas and have access to ultrasound (US) on each unit. However, the US education and use of POCUS by APPs is lacking.

Methods: A survey was distributed to all APPs at an urban academic medical center to query years of practice, POCUS training, frequency of use, most common POCUS images obtained and confidence in interpreting images obtained.

Results: Thirty-seven APPs responded to the survey, 91% were nurse practitioners (NPs) and 8% were physician assistants (PAs), with the majority practicing less than two years. A third of respondents worked in critical care, followed by consult service, outpatient, and intermediate care step down. Only 32% received formal POCUS education, while 57% did not. Greater than 50% responded that formal training would increase the use of POCUS in their practice. A significant number of respondents stated they lacked confidence in obtaining and interpreting images into clinical practice.

Conclusions: The infrequent use of bedside POCUS by CC APPs results in delayed diagnosis and management, increased risk of poor patient outcomes and prolonged hospital length of stay. Providing formal POCUS education to all acute care APPs would improve confidence, competence and prioritize the use of POCUS; therefore, expediting diagnosis and management of time sensitive critical conditions.