Background The literature shows increasing use of ultrasound within the hospice setting. Our hospice has been using point of care portable ultrasound scanning (USS) to enhance patient care, by answering a specific clinical question, since 2010. We feel USS has transformed the patient experience since its introduction to the service. Previously presented data from Dec 2010 to Mar 2014 shows that 158 patients had 286 scanning episodes resulting in 164 procedures. The perception is that USS use continues to increase.
Aim To ensure that the use of USS within hospice use is to answer specific clinical questions and to assess frequency of use within a single week.
Method Retrospective snapshot review of one week of point of care ultrasound in a ten bedded hospice setting. Patients and scanning episodes identified by a search of memory on ultrasound machine and corresponding entry on electronic clinical record.
Results During this week there were 12 separate scanning episodes (3 inpatient and 4 outpatients) by 3 doctors resulting in 8 procedures. Each answered a clinical question – Is urinary retention present? (2 patients: 1 procedure); is there a drainable pleural effusion? (2 patients: 2 procedures); Is there drainable ascites? (3 patients: 2 procedures); Location of peripheral nerve for nerve block (1 patient: 3 procedures).
Conclusion This snapshot audit confirms that point of care USS is being used extensively within the hospice as part of the clinical examination alongside the stethoscope. It is being used appropriately to answer specific clinical questions, leading to decreased admission to intervention time and hence faster symptom relief with less upheaval for patients. USS enables the hospice to provide a responsive service, to arrange planned admission for increasingly symptomatic patients allowing for necessary blood tests and investigations. Data for the year 2014/15 will be available for the conference presentation.
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