Effect of a point-of-care ultrasound (POCUS) curriculum on emergency department soft tissue management.

IF 3.4 Q2 Medicine Ultrasound Journal Pub Date : 2022-10-21 DOI:10.1186/s13089-022-00292-4
Benjamin K Nti, Whitney Phillips, Elisa Sarmiento, Frances Russell
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Abstract

Background: Pediatric emergency department (ED) visits for superficial skin and soft tissue infections (SSTI) have steadily been increasing and point-of-care ultrasound (POCUS) continues to be an effective modality to improve management and shorter ED length of stays (LOS).

Objective: We sought to determine the impact of a soft tissue POCUS curriculum on POCUS utilization, ED LOS, and cost-effectiveness.

Methods: This was a retrospective pre- and post-interventional study of pediatric patients aged 0 to 17 years. Patients presenting to ED with international classification of disease 9 or 10 code for abscess or cellulitis were included. Data were collected a year before and after curriculum implementation with a 1-year washout training period. Training included continuing medical education, greater than 25 quality assured examinations, and a post-test. We compared diagnostic imaging type, ED LOS, and mean charges in patients with SSTI.

Results: We analyzed data on 119 total patients, 38 pre- and 81 post-intervention. We found a significant increase in the total number of POCUS examinations performed pre- to post-curriculum intervention, 26 vs. 59 (p = 0.0017). Mean total charges were significantly decreased from $3,762 (± 270) to $2,622 (± 158; p = 0.0009). There was a significant trend towards a decrease in average ED LOS 282 (standard error of mean [SEM] ± 19) vs 185 (± 13) minutes (p = 0.0001).

Conclusions: Implementation of a soft tissue POCUS curriculum in a pediatric ED was associated with increased POCUS use, decreased LOS, and lower cost. These findings highlight the importance of POCUS education and implementation in the management of pediatric SSTI.

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即时超声(POCUS)课程对急诊科软组织管理的影响。
背景:儿科急诊科(ED)对浅表皮肤和软组织感染(SSTI)的访问一直在稳步增加,即时超声(POCUS)仍然是改善管理和缩短ED住院时间(LOS)的有效方式。目的:我们试图确定软组织POCUS课程对POCUS使用率、ED LOS和成本效益的影响。方法:这是一项0 - 17岁儿童患者介入前和介入后的回顾性研究。以国际疾病分类9或10码为脓肿或蜂窝织炎的ED患者包括在内。数据收集于课程实施前后一年,并进行为期一年的洗脱期培训。培训包括继续医学教育、25次以上有质量保证的考试和一次事后测试。我们比较了SSTI患者的诊断影像类型、ED LOS和平均收费。结果:我们分析了119例患者的数据,干预前38例,干预后81例。我们发现在课程干预前后进行POCUS检查的总次数显著增加,26次对59次(p = 0.0017)。平均总费用从3762美元(±270美元)显著下降到2622美元(±158美元);p = 0.0009)。平均ED LOS有明显的下降趋势,282(平均[SEM]标准误差±19)比185(±13)分钟(p = 0.0001)。结论:在儿科急诊科实施软组织POCUS课程可以增加POCUS的使用,降低LOS和降低成本。这些发现强调了POCUS教育和实施在儿童SSTI管理中的重要性。
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来源期刊
Ultrasound Journal
Ultrasound Journal Health Professions-Radiological and Ultrasound Technology
CiteScore
6.80
自引率
2.90%
发文量
45
审稿时长
22 weeks
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