Fokusert ultralyd utført av sykepleiere for å kartlegge hjertesykdom. En systematisk litteraturstudie

Abstract

Title: Use of Focused Cardiac Ultrasound by Nurses. A systematic review

Background: Heart disease causes a number of symptoms that are difficult for both experienced nurses and physicians to detect based on physical examination. Focused ultrasound is a limited scanning protocol that quickly can discover and provide valuable information related for heart disease. The use of ultrasound is increasing in emergency and intensive care medicine, but there is a lack of a systematic review that examines nurses' precision in performing and interpreting ultrasound, related to screening and treatment of heart disease.

Aim: The aim of this systematic review was to describe nurses’ precision in performing and interpreting ultrasound related to primary and secondary conditions of heart disease.

Methods:

The systematic review utilized Booth and colleagues’ methodological approach and was reported according to the PRISMA 2020 checklist. Systematic searches in the databases Cinahl, Embase and Medline were conducted on 21.12.2021. Studies were included if they had a 1) quantitative design; 2) included hospitalized patients aged 18 years or older; 3) nurses performed and/or interpreting ultrasound (and focused echocardiography) related to primary and secondary conditions of heart disease; 4) nurses performance and/or interpretation of ultrasound were compared against expert; and 5) articles written in English, Norwegian, Swedish or Danish in peer-reviewed journals. Pairs of authors independently assessed eligibility and extracted data. Quality appraisal and risk of bias was conducted using checklists from Joanna Briggs Institute. Results were summarized in a narrative format.

Result: Twelve studies met inclusion criteria. Precision in feasibility resulted in 57.4%- 98.8% against expert.  Results of interpretation precision was r = 0.59-0.96, sensitivity 64-98%, specificity 51-98%, positive predictive value 74-100%, negative predictive value 82%-98% against expert.

Conclusion: Nurses can obtain knowledge to perform and interpret focused ultrasound in the cardiac region. Precision appears to depend on training, clinical setting, the extent of the ultrasound examinations and the anatomical area of the cardiac region.

Keywords: critical care nurses, decision-making, systematic review, ultrasound, heart