Feasibility & Accuracy of Nurse-Performed POCUS
Research type
Research Study
Full title
Diagnostic accuracy of point-of-care ultrasound by community nurses for the detection of left ventricular systolic function.
IRAS ID
255744
Contact name
Sophie Moosavi
Contact email
Sponsor organisation
Swansea University
Duration of Study in the UK
0 years, 9 months, 17 days
Research summary
This proof of concept formal diagnostic accuracy study aims to assess the accuracy and reliability of nurse-led point-of-care ultrasound (POCUS) for detecting systolic heart failure (HF).
HF prevalence is increasing, particularly in the elderly. Earlier diagnosis enables earlier initiation of treatment which can improve quality-of-life and outcomes. However, making a diagnosis at the point of presentation can be difficult because the clinical examination and first-line tests lack accuracy for differentiating between causes of shortness of breath. This means that additional tests are often required. The delay in diagnosis can be significant and also result in more appointments, generating additional expenditure. New, miniaturised, hand-held ultrasound machines offer the tantalising prospect of providing a more accurate ‘triage’ test at the point-of-care.
In Wales, Acute Clinical Teams provide medical care in domiciliary environments. Individuals referred to these teams are frequently older with a high prevalence of HF and co-morbidities. We believe that adding POCUS to the physical examination in this setting, could offer more effective and efficient healthcare for those with suspected HF.
Current literature relating to POCUS use by nurses has focused on hospital and outpatient settings. There is limited evidence on the accuracy of POCUS in the community setting or to show that it changes clinical outcomes. In a future study we hope to rigorously assess whether nurses can use POCUS in the community setting to improve the accuracy of the tentative diagnosis and to make the patient management process more efficient and effective. However, before this is possible, evidence regarding the feasibility and accuracy of POCUS performed by community nurses is needed (pathway to portfolio study). Therefore we propose conducting a formal diagnostic accuracy study of nurse-performed POCUS to assess heart function in the over 60ys at the Health and Wellbeing Academy (Swansea University) prior to testing in the clinical environment.
REC name
Wales REC 6
REC reference
20/WA/0119
Date of REC Opinion
17 Apr 2020
REC opinion
Favourable Opinion