International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya
Background. While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability...
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Wiley
2018-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2018/7328465 |
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| author | Fareen Zaver Keith Boniface Benjamin Wachira Grace Wanjiku Hamid Shokoohi |
| author_facet | Fareen Zaver Keith Boniface Benjamin Wachira Grace Wanjiku Hamid Shokoohi |
| author_sort | Fareen Zaver |
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| description | Background. While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Objective. We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment. Methods. Prior to an US-guided CVC placement training course conducted at the Aga Khan University Hospital in Nairobi, Kenya, physicians were asked to complete a survey to determine previous experience and perceived barriers. Survey responses were analyzed using summary statistics and the Rank-Sum test based on different specialty, gender, and previous US experience. Results. There were 23 physicians who completed the course and the survey. 52% (95% CI: 0.30–0.73) had put in >20 CVCs. 21.7% (95% CI: 0.08–0.44) of participants had previous US training, but none in the use of US for CVC insertion. The respondents expressed agreement with statements describing the ease of the use and improved success rate with US guidance. There was less agreement to statements describing the relative convenience and cost effectiveness of US CVC placement compared to the landmark technique. The main perceived barriers to utilization of US guidance included lack of training and limited availability of US equipment and sterile sheaths. Conclusion. Perceived barriers to US-guided CVC placement in our population closely mirrored those found among North American physicians, including lack of training and limited availability of US machines and equipment. These barriers have the potential to be addressed by targeted educational and administrative interventions. |
| format | Article |
| id | doaj-art-6d70077391c94e9683d81025067ceac6 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-6d70077391c94e9683d81025067ceac62025-02-03T05:48:20ZengWileyEmergency Medicine International2090-28402090-28592018-01-01201810.1155/2018/73284657328465International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, KenyaFareen Zaver0Keith Boniface1Benjamin Wachira2Grace Wanjiku3Hamid Shokoohi4George Washington University, 2120 L Street NW, Suite 450, Washington, DC 2003, USAGeorge Washington University, 2120 L Street NW, Suite 450, Washington, DC 2003, USAAga Khan University Hospital, Third Parklands Avenue, Limuru Road, Nairobi 00100, KenyaBrown University, Box G-A1, Providence, RI 02912, USAGeorge Washington University, 2120 L Street NW, Suite 450, Washington, DC 2003, USABackground. While ultrasound (US) use for internal jugular central venous catheter (CVC) placement is standard of care in North America, most developing countries have not adopted this practice. Previous surveys of North American physicians have identified lack of training and equipment availability as the most important barriers to the use of US. Objective. We sought to identify perceived barriers to the use of US to guide CVC insertion in a resource-constrained environment. Methods. Prior to an US-guided CVC placement training course conducted at the Aga Khan University Hospital in Nairobi, Kenya, physicians were asked to complete a survey to determine previous experience and perceived barriers. Survey responses were analyzed using summary statistics and the Rank-Sum test based on different specialty, gender, and previous US experience. Results. There were 23 physicians who completed the course and the survey. 52% (95% CI: 0.30–0.73) had put in >20 CVCs. 21.7% (95% CI: 0.08–0.44) of participants had previous US training, but none in the use of US for CVC insertion. The respondents expressed agreement with statements describing the ease of the use and improved success rate with US guidance. There was less agreement to statements describing the relative convenience and cost effectiveness of US CVC placement compared to the landmark technique. The main perceived barriers to utilization of US guidance included lack of training and limited availability of US equipment and sterile sheaths. Conclusion. Perceived barriers to US-guided CVC placement in our population closely mirrored those found among North American physicians, including lack of training and limited availability of US machines and equipment. These barriers have the potential to be addressed by targeted educational and administrative interventions.http://dx.doi.org/10.1155/2018/7328465 |
| spellingShingle | Fareen Zaver Keith Boniface Benjamin Wachira Grace Wanjiku Hamid Shokoohi International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya Emergency Medicine International |
| title | International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya |
| title_full | International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya |
| title_fullStr | International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya |
| title_full_unstemmed | International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya |
| title_short | International Scope of Emergency Ultrasound: Barriers in Applying Ultrasound to Guide Central Line Placement by Providers in Nairobi, Kenya |
| title_sort | international scope of emergency ultrasound barriers in applying ultrasound to guide central line placement by providers in nairobi kenya |
| url | http://dx.doi.org/10.1155/2018/7328465 |
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