Aplicabilidade do ultrassom point-of-care e competências profissionais de enfermeiros de cuidados críticos

Abstract

Objective: To describe the landscape of the use of point-of-care ultrasound (POCUS) by nurses in the context of critical patient care, focusing on the characterization of the professional competencies involved, the factors influencing its adoption, and the assessment of the applicability and usability of this technology in clinical practice. Method: This study is characterized as descriptive, employing a mixed-methods approach, and was conducted with nurses working in adult intensive care units and intra- and prehospital emergency services in the state of Minas Gerais, Brazil. Data collection was performed using a structured questionnaire comprising sociodemographic variables. In addition, semi-structured interviews were conducted with professionals who reported using point-of-care ultrasound in their clinical practice. All participants, regardless of their use of the tool, completed the Competency Assessment Questionnaire. Nurses who reported using ultrasound also completed the System Usability Scale (SUS), aiming to measure their perception of the resource’s usability and to relate it to self-perceived competencies. Data analysis involved statistical procedures and lexical analysis performed using the IRaMuTeQ software, applying Descending Hierarchical Classification, Word Cloud, and Similarity Analysis for data interpretation. Results: A total of 33 nurses participated in the study, of whom 63.63% reported using point-of-care ultrasound in their clinical practice. Among professionals using the tool, there was a predominance of females (71.43%), with the highest concentration in the 31–39-year age group (52.38%). Regarding academic background, 33.33% held postgraduate qualifications in intensive care, and 80.96% had more than one year of professional experience after graduation. Concerning the clinical applications of ultrasound, all 21 nurses who used the technology reported employing it primarily for vascular access procedures. Additionally, 47.62% indicated its use for bladder volume assessment. Analysis of the Competency Assessment Questionnaire revealed good to high levels of competency among participants. A statistically significant association was observed between years since graduation (p = 0.019) and duration of clinical practice (p = 0.035) with the level of overall competency. Competencies and System Usability Scale results showed no statistically significant association (p = 0.387). Lexical analysis conducted using IRaMuTeQ resulted in the formation of five classes.