Point‐of‐care ultrasound in rural New Zealand: Safety, quality and impact on patient management.

Objective: To evaluate the safety, quality and impact of point‐of‐care ultrasound on patient management when performed by rural generalist doctors. Design: Cross‐sectional descriptive study. Setting: Six rural small hospitals serving a range of communities in rural New Zealand. Participants: All generalist doctors practising ultrasound in the study hospitals. Main outcome measures: Technical quality, accuracy, impact on diagnostic certainty, patient disposition and overall patient care. Result: Participants correctly interpreted 90% of images and a similar percentage of point‐of‐care ultrasound findings when compared with the results of formal imaging or the final diagnosis. In total, 87% of scans contributed to the diagnostic process, changing the diagnostic probability. There was a 4% overall reduction in the number of patients needing hospital admission or transfer to an urban base hospital. The overall impact on patient care was positive for 71% of point‐of‐care ultrasound scans. Three percent of scans had the potential for patient harm. Conclusion: Rural generalists' practise a broad scope of point‐of‐care ultrasound that, when used as a part of the full clinical assessment, has a positive impact on patient care, improving diagnostic certainty and reducing the need for hospital admission and inter‐hospital transfer. There are challenges in learning and maintaining the skills needed to practise a high standard of point‐of‐care ultrasound in this context. Further consideration needs to be given to the development safe scopes of practice, training, credentialing and quality assurance. [ABSTRACT FROM AUTHOR]