Acceptability and Feasibility of Using Point of Care Ultrasound Scan Among Health Care Professionals in Eastern Uganda: a Cross-sectional Study

Acceptability and Feasibility of Using Point of Care Ultrasound Scan Among Health Care Professionals in Eastern Uganda: a Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Acceptability and Feasibility of Using Point of Care Ultrasound Scan Among Health Care Professionals in Eastern Uganda: a Cross-sectional Study William Okiror, Cate Namayanja, Charles Benard Okalebo, Egiru Emma Isiah Eregu, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3880794/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Health care professionals (HCPs) face diagnostic challenges especially when confronted with undifferentiated critically ill patients at emergency care unit. The need for improvement in diagnostic capabilities is greater in settings with limited clinical, radiological and laboratory capabilities. Point-of-care ultrasound (POCUS) has been suggested to offer some diagnostic solutions in resource-limited settings. This study aimed to assess the acceptability and feasibility of using POCUS for diagnosing patients at health facilities in resource-limited settings in Eastern Uganda. Methods This cross-sectional study purposively enrolled HCPs in Eastern Uganda. Data were analyzed using the STATA statistical analysis software for univariate analysis and presented using frequency tables and proportions. Results A total of 52 HCPs of various cadres were studied, including 22/52 (42.3%) nurses, 15/52 (28.8%) medical officers, 10/52 (19.2%) clinical officers, 2/52 (3.8%) intern nurses, and 2/52 (3.8%) specialists. Over one half 27/52 (51.9%) had heard of POCUS of whom 9/27 (33.3%) had formal training with 7/27 (25.9%) of them having used POCUS. While 25/27 (92.6%) had witnessed someone performing POCUS diagnostic procedure. The majority of HCPs 41/52 (78.8%) expressed interest in undergoing a training on POCUS, moreover 42/52 (80.8%) thought it was helpful in medical practice. The common barriers on use of POCUS cited were high cost of equipment and training, lack of an ultrasound machine, lack of mentors and time to train learners. Conclusion POCUS use is acceptable among HCPs, but its potential in these settings is dependent on overcoming barriers to its use. Critical Care & Emergency Medicine Point of care ultrasound scan acceptability feasibility health care professionals Figures Figure 1 Figure 2 BACKGROUND In resource-limited settings, critically sick children often present to emergency paediatric care units with undifferentiated life-threatening illnesses. The spectrum of disease is wide and may involve one or more body systems [ 1 ]. Most data from these settings indicate that critically sick children have a high risk of death, and often within the first 24 hours of hospital admission [ 1 ]. Improvement of clinical outcomes for children admitted with critical illnesses is contingent on prompt triage, accurate diagnosis, and early appropriate treatment. In well-resourced settings, use of POCUS is a widely used imaging modality designed for rapid diagnosis. While it is being promoted in well-resourced settings, there are knowledge challenges that exist in resource-limited settings. For instance, acceptability and feasibility of the use of POCUS is not well explored in poorly resourced settings where they would most be needed [ 2 ]. In addition to assessing the feasibility of POCUS use in low-resource settings, it is important to understand the attitudes and perceptions surrounding any novel tool to increase uptake. Previous data have reported on the attitudes of primarily physicians to POCUS use [ 3 – 5 ], however, in LMICs where task shifting is common, few similar data have been reported. Our study aimed to assess the acceptability and feasibility of using POCUS for undifferentiated critically ill children presetting to health facilities in eastern Uganda. METHODS AND MATERIALS Study area and sites The study was conducted in 12 hospitals including 10 district hospitals of Atutur, Bududa, Bugiri, Busolwe, Iganga, Kamuli, Kapchorwa, Katakwi, Pallisa and Tororo and two regional referral hospitals of Mbale and Soroti; in Eastern Uganda. A cross-sectional convenience sample of 52 clinicians was selected across 12 health facilities in the study region between September 2019 and March 2021. Those clinicians who were on duty at the time of study were included in the study. Data management and analysis A structured questionnaire was used to collect data from HCPs. Variable included attitudes, understanding, anticipated challenges and anticipated uses for POCUS. Data were analysed using STATA version 16 (STATA Corporation, College Station, TX). Continuous variables were represented as an average with standard deviation (SD) or as a median with an interquartile range (IQR) depending on distribution. Nominal variables were displayed with absolute numbers and percentages. Data were presented using frequency tables and proportions. Authorization and Ethical considerations Prior to the launch of data collection, ethical approvals were obtained to conduct this study from the Mbale Regional Referral Hospital Research Ethics Committee (MRRH-REC) and Uganda National Council for Science and Technology (UNCST). In addition, letters of administrative clearance were obtained from respective health facilities. Informed consent was obtained from the HCPs by signing the approved informed consent form. RESULTS Acceptability of POCUS for childhood evaluation: A total of 52 health care providers (HCPs) were interviewed. The majority were females (57.7%) nurses (42.3%). Demographic information on participants is summarised in Table 1. Over half of the Health Care Professionals (HCPs) 27/52 (51.9%) knew about POCUS of whom only 7/27 (25.9%) had ever used POCUS in their clinical work, while 9/27 (33.3%) had ever undergone formal training in POCUS. Similarly, 25/27 (92.6%) had witnessed someone performing POCUS. A majority of the HCPs, 35/52 (67.3%), thought they were not competent in POCUS and only 3/52 (5.8%) were very competent in POCUS. The majority 41/52 (78.8%) expressed that they would be interested in undergoing a training on POCUS, and 42/52 (80.8%) thought POCUS was helpful in medical practice. The highest perceived POCUS indications were: liver (Hepatic Mass), cardiac, focused assessment with sonography in trauma (FAST), Renal (renal mass and hydronephrosis), and bedside gall bladder and bile duct evaluation (see Fig. 1 for all indications). POCUS was rated highly on usefulness in the practice of medicine (Mean = 9.6; SD = 1.00). The sample mean of interest in undergoing further training in POCUS is 8.9 (SD = 1.3) (0 = not interested, 10 = very interested). Overall, HCPs highlighted the rapid diagnostic ability of POCUS, which included guiding definitive treatment during initial consultation instead of ‘guessing’ the diagnosis. Table 1: Health workers Response demographic characteristics Category frequency % n=52 Gender Male 22 42.3 Female 30 57.7 Age group 18–24 years old 2 3.8 25–29 years old 5 9.6 30–34 years old 19 36.5 35–39 years old 6 11.5 40–44 years old 6 11.5 > 44 years old 14 26.9 Years of working in the hospital ≤ 1 year 3 7.3 2–5 years 30 73.1 > 5 years 8 19.6 Professional groups Medical officers 15 28.8 Nurses 22 42.3 Clinical officers 10 19.2 Intern nurse 2 3.8 Consultants 2 3.8 Knowledge of POCUS (yes) 27 51.9 Use of POCUS at clinical work (yes) 7 13.5 Training of POCUS at medical school (yes) 9 17.3 Interested in undergoing training on POCUS (yes) 41 78.8 Think POCUS is helpful in medical practice (yes) 42 80.8 Feasibility of POCUS The top five barriers identified by the HCPS were: cost of a POCUS machine, lack of a POCUS machine, lack of mentors, cost of training, and time to train learners (see Fig. 2 ). Identified costs associated with successful POCUS implementation included equipment, appropriately trained staff and time. About half of the HCPs interviewed expressed concern with the cost of the POCUS technology as a potential barrier for the widespread implementation of POCUS as an extension of clinical examination diagnostic. Currently, POCUS is not a readily available diagnostic tool in their settings and would require the purchase of a number of devices for use, cost of training hospital members and cost to train learners. HCPs had different concerns about safe storage of the device and concern about maintenance of the equipment over time. In addition to the equipment itself, HCPs also commented on the importance of recruiting and training staff to perform diagnostics using POCUS. About half of the HCPs quoted that successful POCUS implementation relied on adequately trained staff to operate and interpret POCUS results. More than a half of the HCPs 29/52 (55.8%) preferred a small portable machine shared by all and brought to patient’s bedside. DISCUSSION Our study found that POCUS is not novel among HCPs in Eastern Uganda as more than half of the HCPs had heard of POCUS. However, POCUS is not a routine diagnostic tool in health facilities in the region. This is possibly because of the prohibitive cost as cited by the respondents or lack of policy to include POCUS as a routine diagnostic tool. A majority of HCPs had never undergone formal training on POCUS use. This was viewed as a hindrance to POCUS use in the region. Despite this, a majority of HCPs expressed interest in in undergoing training on POCUS, and thought that it was helpful in medical practice. Our data are similar to those on a study by Riaz et al in 2021, which also assessed attitudes specific to ultrasound in children in a low-resource setting, usefulness of POCUS was highly rated and the value of its diagnostic utility was highlighted [ 6 ]. In regard to feasibility, this study showed that HCPs perceived that it was feasible to integrate POCUS across health facilities with certain caveats including a preference for portable ultrasound machines, which can be used and shared across departments. The HCPs also identified several barriers to POCUS implementation use such as cost of the machine, lack of a machine, lack of mentors, cost of training, and time to train learners. These barriers reflect similar findings from other authors who have evaluated barriers in LMICs [ 3 , 6 , 7 ]. At the time of our study, POCUS was not widely practiced in eastern Uganda, especially at the rural and district levels. Increasingly HCPs are recognizing the relevance of POCUS for diagnostics and daily practice. Perhaps the low level of practice reflects the significant barriers in implementation of POCUS programs in eastern Uganda. Overcoming these barriers will require policy changes, stakeholder commitment and availability of POCUS mentors such as radiologists, emergency physicians, intensivists and cardiologists. Despite such challenges, a few low-resource settings have demonstrated successes in implementation of longitudinal POCUS programs [ 8 – 12 ]. We believe that several of these barriers can be addressed as ultrasound machines become more portable and more affordable, and with options for remote training to increase mentors [ 13 – 15 ]. Our study had some limitations. Only HCPs attached to the pediatric wards were selected to participate so we did not get a wider view among other HCPs. However, since we were evaluating POCUS for undifferentiated children, these HCPs were the most reliable to provide such information and therefore, interpretation of these results should be limited to these settings. We conducted a convenience sample technique which could have led to a selection bias. This was still useful because we sampled HCP in the frontline of care. Conclusions POCUS is generally acceptable in Eastern Uganda for diagnosis children with undifferentiated critical illnesses. Addressing the main barriers to POCUS feasibility such as cost of the machine, lack of machines, lack of mentors, cost of training and time to train learners, will be key for its integration in routine clinical practice in eastern Uganda. List of abbreviations FAST Focused Assessment with Sonography in Trauma HCPs Health Care Professionals IQR Interquartile Range LMICs Low- and Middle-Income Countries MCRI Mbale Clinical Research Institute MRRH-REC Mbale Regional Referral Hospital Research Ethics Committee PET Score Paediatric Emergency Triage Score POCUS Point of Care Ultrasound SD Standard Deviation UNCST Uganda National Council for Science and Technology Declarations Acknowledgements We do acknowledge all the health care professionals from the study health facilities for their various contributions to this work. Author contribution P-OO conceived and supervised the study. WO collected the data and wrote the first draft of the manuscript. CN designed the database and conducted the data analysis. CMN, PO, EEIE, JNS and GP participated in writing the manuscript. All authors contributed to editing the paper and approved the final submission. Funding Dr William Okiror was sponsored by Mbale Clinical Research Institute to do his Masters of Public Health through which these data were collected. Availability of data & materials The study data are available by request to the corresponding author. Compliance with ethical standards The study conformed to the provisions of ethical standards in Uganda. Competing interest The authors declare they have no competing interest. Ethics approval and consent to participate The study was approved by the Mbale Regional Referral Hospital Research & Ethics Committee. Local permission to conduct the study was obtained from the respective hospital heads. Consent to Publish The Mbale Clinical Research Institute (MCRI, www.mcri.ac.ug), a research entity affiliated to the Uganda National Health Research Organization, approved the publication of this manuscript. References George, E.C., et al., Predicting mortality in sick African children: the FEAST Paediatric Emergency Triage (PET) Score. BMC Med, 2015. 13 : p. 174. Sanders, D. and A. Haines, 2006Implementation research is needed to achieve international health goals. PLoS Med 3e186. 10 . Shah, S., et al., Perceived barriers in the use of ultrasound in developing countries. Critical ultrasound journal, 2015. 7 (1): p. 1-5. Peh, W.M. and M.L. Kang, A pilot survey on an understanding of point of care bedside ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest and barriers to training. Proceedings of Singapore Healthcare, 2018. 27 (2): p. 85-95. Wong, J., et al., Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions. The Ultrasound Journal, 2020. 12 (1): p. 1-7. Riaz, A., et al., Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study. BMJ open, 2021. 11 (3): p. e042547. Maw, A.M., et al., Stakeholder perceptions of point-of-care ultrasound implementation in resource-limited settings. Diagnostics, 2019. 9 (4): p. 153. Rupp, J.D., S.D. Jagjit, and R.M. Ferre, Emergency Ultrasound Training Program in Guyana: Systematic Credentialing Process in a Resource ‐ limited Setting. AEM Education and Training, 2019. 3 (2): p. 197-199. Bell, G., B. Wachira, and G. Denning, A pilot training program for point-of-care ultrasound in Kenya. African Journal of Emergency Medicine, 2016. 6 (3): p. 132-137. Shah, S., et al., Development of an ultrasound training curriculum in a limited resource international setting: successes and challenges of ultrasound training in rural Rwanda. International journal of emergency medicine, 2008. 1 (3): p. 193-196. Stolz, L.A., et al., Point ‐ of ‐ care ultrasound education for non ‐ physician clinicians in a resource ‐ limited emergency department. Tropical medicine & international health, 2015. 20 (8): p. 1067-1072. Schmidt, J., et al., Training for Pediatric Cardiac and Pulmonary Point of Care Ultrasound in Eastern Uganda. Ultrasound in Medicine & Biology, 2022. Dreyfuss, A., et al., A novel multimodal approach to point-of-care ultrasound education in low-resource settings. Western Journal of Emergency Medicine, 2020. 21 (4): p. 1017. Terry, B., et al., Rapid, remote education for point-of-care ultrasound among non-physician emergency care providers in a resource limited setting. African Journal of Emergency Medicine, 2019. 9 (3): p. 140-144. Becker, D.M., et al., The use of portable ultrasound devices in low ‐ and middle ‐ income countries: a systematic review of the literature. Tropical Medicine & International Health, 2016. 21 (3): p. 294-311. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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The spectrum of disease is wide and may involve one or more body systems [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Most data from these settings indicate that critically sick children have a high risk of death, and often within the first 24 hours of hospital admission [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Improvement of clinical outcomes for children admitted with critical illnesses is contingent on prompt triage, accurate diagnosis, and early appropriate treatment.\u003c/p\u003e \u003cp\u003eIn well-resourced settings, use of POCUS is a widely used imaging modality designed for rapid diagnosis. While it is being promoted in well-resourced settings, there are knowledge challenges that exist in resource-limited settings. For instance, acceptability and feasibility of the use of POCUS is not well explored in poorly resourced settings where they would most be needed [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In addition to assessing the feasibility of POCUS use in low-resource settings, it is important to understand the attitudes and perceptions surrounding any novel tool to increase uptake. Previous data have reported on the attitudes of primarily physicians to POCUS use [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], however, in LMICs where task shifting is common, few similar data have been reported.\u003c/p\u003e \u003cp\u003eOur study aimed to assess the acceptability and feasibility of using POCUS for undifferentiated critically ill children presetting to health facilities in eastern Uganda.\u003c/p\u003e"},{"header":"METHODS AND MATERIALS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and sites\u003c/h2\u003e \u003cp\u003e The study was conducted in 12 hospitals including 10 district hospitals of Atutur, Bududa, Bugiri, Busolwe, Iganga, Kamuli, Kapchorwa, Katakwi, Pallisa and Tororo and two regional referral hospitals of Mbale and Soroti; in Eastern Uganda. A cross-sectional convenience sample of 52 clinicians was selected across 12 health facilities in the study region between September 2019 and March 2021. Those clinicians who were on duty at the time of study were included in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData management and analysis\u003c/h2\u003e \u003cp\u003eA structured questionnaire was used to collect data from HCPs. Variable included attitudes, understanding, anticipated challenges and anticipated uses for POCUS. Data were analysed using STATA version 16 (STATA Corporation, College Station, TX). Continuous variables were represented as an average with standard deviation (SD) or as a median with an interquartile range (IQR) depending on distribution. Nominal variables were displayed with absolute numbers and percentages. Data were presented using frequency tables and proportions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eAuthorization and Ethical considerations\u003c/h2\u003e \u003cp\u003e Prior to the launch of data collection, ethical approvals were obtained to conduct this study from the Mbale Regional Referral Hospital Research Ethics Committee (MRRH-REC) and Uganda National Council for Science and Technology (UNCST). In addition, letters of administrative clearance were obtained from respective health facilities. Informed consent was obtained from the HCPs by signing the approved informed consent form.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n\u003ch2\u003eAcceptability of POCUS for childhood evaluation:\u003c/h2\u003e\n\u003cp\u003eA total of 52 health care providers (HCPs) were interviewed. The majority were females (57.7%) nurses (42.3%). Demographic information on participants is summarised in Table\u0026nbsp;1.\u003c/p\u003e\n\u003cp\u003eOver half of the Health Care Professionals (HCPs) 27/52 (51.9%) knew about POCUS of whom only 7/27 (25.9%) had ever used POCUS in their clinical work, while 9/27 (33.3%) had ever undergone formal training in POCUS. Similarly, 25/27 (92.6%) had witnessed someone performing POCUS. A majority of the HCPs, 35/52 (67.3%), thought they were not competent in POCUS and only 3/52 (5.8%) were very competent in POCUS.\u003c/p\u003e\n\u003cp\u003eThe majority 41/52 (78.8%) expressed that they would be interested in undergoing a training on POCUS, and 42/52 (80.8%) thought POCUS was helpful in medical practice. The highest perceived POCUS indications were: liver (Hepatic Mass), cardiac, focused assessment with sonography in trauma (FAST), Renal (renal mass and hydronephrosis), and bedside gall bladder and bile duct evaluation (see Fig.\u0026nbsp;1 for all indications). POCUS was rated highly on usefulness in the practice of medicine (Mean\u0026thinsp;=\u0026thinsp;9.6; SD\u0026thinsp;=\u0026thinsp;1.00). The sample mean of interest in undergoing further training in POCUS is 8.9 (SD\u0026thinsp;=\u0026thinsp;1.3) (0\u0026thinsp;=\u0026thinsp;not interested, 10\u0026thinsp;=\u0026thinsp;very interested). Overall, HCPs highlighted the rapid diagnostic ability of POCUS, which included guiding definitive treatment during initial consultation instead of \u0026lsquo;guessing\u0026rsquo; the diagnosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;1: Health workers Response demographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Taba\" border=\"1\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u003cstrong\u003efrequency\u003c/strong\u003e\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u003cstrong\u003en=52\u003c/strong\u003e\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e57.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u0026ndash;24 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u0026ndash;29 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u0026ndash;34 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u0026ndash;39 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40\u0026ndash;44 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;44 years old\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eYears of working in the hospital\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026le;\u0026thinsp;1 year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u0026ndash;5 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e73.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eProfessional groups\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMedical officers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNurses\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eClinical officers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntern nurse\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eConsultants\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge of POCUS (yes)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eUse of POCUS at clinical work (yes)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTraining of POCUS at medical school (yes)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eInterested in undergoing training on POCUS (yes)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e78.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eThink POCUS is helpful in medical practice (yes)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e80.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section3\"\u003e\n\u003ch2\u003eFeasibility of POCUS\u003c/h2\u003e\n\u003cp\u003eThe top five barriers identified by the HCPS were: cost of a POCUS machine, lack of a POCUS machine, lack of mentors, cost of training, and time to train learners (see Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Identified costs associated with successful POCUS implementation included equipment, appropriately trained staff and time. About half of the HCPs interviewed expressed concern with the cost of the POCUS technology as a potential barrier for the widespread implementation of POCUS as an extension of clinical examination diagnostic. Currently, POCUS is not a readily available diagnostic tool in their settings and would require the purchase of a number of devices for use, cost of training hospital members and cost to train learners. HCPs had different concerns about safe storage of the device and concern about maintenance of the equipment over time.\u003c/p\u003e\n\u003cp\u003eIn addition to the equipment itself, HCPs also commented on the importance of recruiting and training staff to perform diagnostics using POCUS. About half of the HCPs quoted that successful POCUS implementation relied on adequately trained staff to operate and interpret POCUS results. More than a half of the HCPs 29/52 (55.8%) preferred a small portable machine shared by all and brought to patient\u0026rsquo;s bedside.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eOur study found that POCUS is not novel among HCPs in Eastern Uganda as more than half of the HCPs had heard of POCUS. However, POCUS is not a routine diagnostic tool in health facilities in the region. This is possibly because of the prohibitive cost as cited by the respondents or lack of policy to include POCUS as a routine diagnostic tool. A majority of HCPs had never undergone formal training on POCUS use. This was viewed as a hindrance to POCUS use in the region. Despite this, a majority of HCPs expressed interest in in undergoing training on POCUS, and thought that it was helpful in medical practice. Our data are similar to those on a study by Riaz et al in 2021, which also assessed attitudes specific to ultrasound in children in a low-resource setting, usefulness of POCUS was highly rated and the value of its diagnostic utility was highlighted [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn regard to feasibility, this study showed that HCPs perceived that it was feasible to integrate POCUS across health facilities with certain caveats including a preference for portable ultrasound machines, which can be used and shared across departments. The HCPs also identified several barriers to POCUS implementation use such as cost of the machine, lack of a machine, lack of mentors, cost of training, and time to train learners. These barriers reflect similar findings from other authors who have evaluated barriers in LMICs [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt the time of our study, POCUS was not widely practiced in eastern Uganda, especially at the rural and district levels. Increasingly HCPs are recognizing the relevance of POCUS for diagnostics and daily practice. Perhaps the low level of practice reflects the significant barriers in implementation of POCUS programs in eastern Uganda. Overcoming these barriers will require policy changes, stakeholder commitment and availability of POCUS mentors such as radiologists, emergency physicians, intensivists and cardiologists. Despite such challenges, a few low-resource settings have demonstrated successes in implementation of longitudinal POCUS programs [\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. We believe that several of these barriers can be addressed as ultrasound machines become more portable and more affordable, and with options for remote training to increase mentors [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Our study had some limitations. Only HCPs attached to the pediatric wards were selected to participate so we did not get a wider view among other HCPs. However, since we were evaluating POCUS for undifferentiated children, these HCPs were the most reliable to provide such information and therefore, interpretation of these results should be limited to these settings. We conducted a convenience sample technique which could have led to a selection bias. This was still useful because we sampled HCP in the frontline of care.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003ePOCUS is generally acceptable in Eastern Uganda for diagnosis children with undifferentiated critical illnesses. Addressing the main barriers to POCUS feasibility such as cost of the machine, lack of machines, lack of mentors, cost of training and time to train learners, will be key for its integration in routine clinical practice in eastern Uganda.\u003c/p\u003e"},{"header":"List of abbreviations","content":"\u003cp\u003eFAST Focused Assessment with Sonography in Trauma\u003c/p\u003e\n\u003cp\u003eHCPs Health Care Professionals\u003c/p\u003e\n\u003cp\u003eIQR Interquartile Range\u003c/p\u003e\n\u003cp\u003eLMICs Low- and Middle-Income Countries\u003c/p\u003e\n\u003cp\u003eMCRI Mbale Clinical Research Institute\u003c/p\u003e\n\u003cp\u003eMRRH-REC Mbale Regional Referral Hospital Research Ethics Committee \u003c/p\u003e\n\u003cp\u003ePET Score Paediatric Emergency Triage Score\u003c/p\u003e\n\u003cp\u003ePOCUS Point of Care Ultrasound\u003c/p\u003e\n\u003cp\u003eSD Standard Deviation\u003c/p\u003e\n\u003cp\u003eUNCST Uganda National Council for Science and Technology\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAcknowledgements\u003c/h2\u003e\n\u003cp\u003eWe do acknowledge all the health care professionals from the study health facilities for their various contributions to this work.\u003c/p\u003e\n\u003ch2\u003eAuthor contribution\u003c/h2\u003e\n\u003cp\u003eP-OO conceived and supervised the study. WO collected the data and wrote the first draft of the manuscript. CN designed the database and conducted the data analysis. CMN, PO, EEIE, JNS and GP participated in writing the manuscript. All authors contributed to editing the paper and approved the final submission.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eDr William Okiror was sponsored by Mbale Clinical Research Institute to do his Masters of Public Health through which these data were collected.\u003c/p\u003e\n\u003ch2\u003eAvailability of data \u0026amp; materials\u003c/h2\u003e\n\u003cp\u003eThe study data are available by request to the corresponding author.\u003c/p\u003e\n\u003ch2\u003eCompliance with ethical standards\u003c/h2\u003e\n\u003cp\u003eThe study conformed to the provisions of ethical standards in Uganda.\u003c/p\u003e\n\u003ch2\u003eCompeting interest\u003c/h2\u003e\n\u003cp\u003eThe authors declare they have no competing interest.\u003c/p\u003e\n\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eThe study was approved by the Mbale Regional Referral Hospital Research \u0026amp; Ethics Committee. Local permission to conduct the study was obtained from the respective hospital heads.\u003c/p\u003e\n\u003ch2\u003eConsent to Publish\u003c/h2\u003e\n\u003cp\u003eThe Mbale Clinical Research Institute (MCRI, www.mcri.ac.ug), a research entity affiliated to the Uganda National Health Research Organization, approved the publication of this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGeorge, E.C., et al., \u003cem\u003ePredicting mortality in sick African children: the FEAST Paediatric Emergency Triage (PET) Score.\u003c/em\u003e BMC Med, 2015. \u003cstrong\u003e13\u003c/strong\u003e: p. 174.\u003c/li\u003e\n\u003cli\u003eSanders, D. and A. Haines, \u003cem\u003e2006Implementation research is needed to achieve international health goals.\u003c/em\u003e PLoS Med 3e186. \u003cstrong\u003e10\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eShah, S., et al., \u003cem\u003ePerceived barriers in the use of ultrasound in developing countries.\u003c/em\u003e Critical ultrasound journal, 2015. \u003cstrong\u003e7\u003c/strong\u003e(1): p. 1-5.\u003c/li\u003e\n\u003cli\u003ePeh, W.M. and M.L. Kang, \u003cem\u003eA pilot survey on an understanding of point of care bedside ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest and barriers to training.\u003c/em\u003e Proceedings of Singapore Healthcare, 2018. \u003cstrong\u003e27\u003c/strong\u003e(2): p. 85-95.\u003c/li\u003e\n\u003cli\u003eWong, J., et al., \u003cem\u003eBarriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions.\u003c/em\u003e The Ultrasound Journal, 2020. \u003cstrong\u003e12\u003c/strong\u003e(1): p. 1-7.\u003c/li\u003e\n\u003cli\u003eRiaz, A., et al., \u003cem\u003eFeasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study.\u003c/em\u003e BMJ open, 2021. \u003cstrong\u003e11\u003c/strong\u003e(3): p. e042547.\u003c/li\u003e\n\u003cli\u003eMaw, A.M., et al., \u003cem\u003eStakeholder perceptions of point-of-care ultrasound implementation in resource-limited settings.\u003c/em\u003e Diagnostics, 2019. \u003cstrong\u003e9\u003c/strong\u003e(4): p. 153.\u003c/li\u003e\n\u003cli\u003eRupp, J.D., S.D. Jagjit, and R.M. Ferre, \u003cem\u003eEmergency Ultrasound Training Program in Guyana: Systematic Credentialing Process in a Resource\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003elimited Setting.\u003c/em\u003e AEM Education and Training, 2019. \u003cstrong\u003e3\u003c/strong\u003e(2): p. 197-199.\u003c/li\u003e\n\u003cli\u003eBell, G., B. Wachira, and G. Denning, \u003cem\u003eA pilot training program for point-of-care ultrasound in Kenya.\u003c/em\u003e African Journal of Emergency Medicine, 2016. \u003cstrong\u003e6\u003c/strong\u003e(3): p. 132-137.\u003c/li\u003e\n\u003cli\u003eShah, S., et al., \u003cem\u003eDevelopment of an ultrasound training curriculum in a limited resource international setting: successes and challenges of ultrasound training in rural Rwanda.\u003c/em\u003e International journal of emergency medicine, 2008. \u003cstrong\u003e1\u003c/strong\u003e(3): p. 193-196.\u003c/li\u003e\n\u003cli\u003eStolz, L.A., et al., \u003cem\u003ePoint\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003eof\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003ecare ultrasound education for non\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003ephysician clinicians in a resource\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003elimited emergency department.\u003c/em\u003e Tropical medicine \u0026amp; international health, 2015. \u003cstrong\u003e20\u003c/strong\u003e(8): p. 1067-1072.\u003c/li\u003e\n\u003cli\u003eSchmidt, J., et al., \u003cem\u003eTraining for Pediatric Cardiac and Pulmonary Point of Care Ultrasound in Eastern Uganda.\u003c/em\u003e Ultrasound in Medicine \u0026amp; Biology, 2022.\u003c/li\u003e\n\u003cli\u003eDreyfuss, A., et al., \u003cem\u003eA novel multimodal approach to point-of-care ultrasound education in low-resource settings.\u003c/em\u003e Western Journal of Emergency Medicine, 2020. \u003cstrong\u003e21\u003c/strong\u003e(4): p. 1017.\u003c/li\u003e\n\u003cli\u003eTerry, B., et al., \u003cem\u003eRapid, remote education for point-of-care ultrasound among non-physician emergency care providers in a resource limited setting.\u003c/em\u003e African Journal of Emergency Medicine, 2019. \u003cstrong\u003e9\u003c/strong\u003e(3): p. 140-144.\u003c/li\u003e\n\u003cli\u003eBecker, D.M., et al., \u003cem\u003eThe use of portable ultrasound devices in low\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003eand middle\u003c/em\u003e\u003cem\u003e‐\u003c/em\u003e\u003cem\u003eincome countries: a systematic review of the literature.\u003c/em\u003e Tropical Medicine \u0026amp; International Health, 2016. \u003cstrong\u003e21\u003c/strong\u003e(3): p. 294-311.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Mbale Clinical Research Institute","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Point of care ultrasound scan, acceptability, feasibility, health care professionals","lastPublishedDoi":"10.21203/rs.3.rs-3880794/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3880794/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHealth care professionals (HCPs) face diagnostic challenges especially when confronted with undifferentiated critically ill patients at emergency care unit. The need for improvement in diagnostic capabilities is greater in settings with limited clinical, radiological and laboratory capabilities. Point-of-care ultrasound (POCUS) has been suggested to offer some diagnostic solutions in resource-limited settings. This study aimed to assess the acceptability and feasibility of using POCUS for diagnosing patients at health facilities in resource-limited settings in Eastern Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study purposively enrolled HCPs in Eastern Uganda. Data were analyzed using the STATA statistical analysis software for univariate analysis and presented using frequency tables and proportions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 52 HCPs of various cadres were studied, including 22/52 (42.3%) nurses, 15/52 (28.8%) medical officers, 10/52 (19.2%) clinical officers, 2/52 (3.8%) intern nurses, and 2/52 (3.8%) specialists. Over one half 27/52 (51.9%) had heard of POCUS of whom 9/27 (33.3%) had formal training with 7/27 (25.9%) of them having used POCUS. While 25/27 (92.6%) had witnessed someone performing POCUS diagnostic procedure. The majority of HCPs 41/52 (78.8%) expressed interest in undergoing a training on POCUS, moreover 42/52 (80.8%) thought it was helpful in medical practice. The common barriers on use of POCUS cited were high cost of equipment and training, lack of an ultrasound machine, lack of mentors and time to train learners.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePOCUS use is acceptable among HCPs, but its potential in these settings is dependent on overcoming barriers to its use.\u003c/p\u003e","manuscriptTitle":"Acceptability and Feasibility of Using Point of Care Ultrasound Scan Among Health Care Professionals in Eastern Uganda: a Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-23 15:55:36","doi":"10.21203/rs.3.rs-3880794/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32442182-9ade-456f-ac8e-2a5d366ef6ab","owner":[],"postedDate":"January 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":28307844,"name":"Critical Care \u0026 Emergency Medicine"}],"tags":[],"updatedAt":"2024-01-23T15:55:36+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-23 15:55:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3880794","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3880794","identity":"rs-3880794","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}