The Experiences of Critical Care Nurses Implementing Point-Of-Care Ultrasound: A Qualitative Study

Abstract

Background: Point-of-care ultrasound (POCUS) has emerged as a transformative tool in critical care, enabling rapid bedside assessment of haemodynamic status, organ dysfunction and procedural guidance. While its integration into physician practice is well established, the expansion of POCUS utilisation by nurses remains limited, particularly in settings where regulatory frameworks and training pathways for nursing-led POCUS are underdeveloped. Understanding nurses' firsthand experiences is crucial to address implementation barriers and optimise this technology's potential to enhance patient safety and nursing autonomy.

Aims: To gain an in-depth understanding of the experiences of intensive care unit nurses in implementing POCUS and provide a basis for promoting the effective application of this technique in clinical settings.

Study design: This qualitative study adopted a descriptive qualitative design to explore nurses' experiences of implementing POCUS. Data were collected through semi-structured, face-to-face interviews conducted between May and October 2023 across four tertiary academic hospitals (Grade III-A) in Hunan Province, China. Purposeful sampling was utilised to recruit 18 critical care nurses with hands-on POCUS experience. Interviews continued until thematic saturation was achieved (no new themes emerging from three consecutive interviews). All interviews were audio-recorded, transcribed verbatim and analysed using Colaizzi's seven-step method, involving iterative coding, theme extraction and member-checking to enhance credibility.

Results: Four main themes and 11 subthemes were identified from the interview responses. The four main themes were: the perceived value of POCUS in intensive care unit (ICU) nursing practice; the effects of POCUS on the nurses themselves; challenges in skill acquisition and training for POCUS; barriers to effective implementation of POCUS.

Conclusions: POCUS has a positive effect on clinical practice by guiding the implementation of care for critically ill patients, improving clinical nursing decisions and enhancing confidence and professional fulfilment among nurses. However, the application of POCUS also faces several challenges and limitations related to equipment costs, resource constraints and patient acceptance. Multidisciplinary collaboration, knowledge and resource sharing and a comprehensive support system are needed to maximise the benefits of POCUS while minimising potential risks.

Relevance to clinical practice: This study highlights the experiences of critical care nurses using POCUS in their practice. Understanding these experiences can guide improvements in nursing education and support the broader use of POCUS in clinical settings. With better training and resources, nurses can enhance patient care through quicker assessments, better monitoring and greater involvement in decision-making, ultimately improving patient outcomes in intensive care.

Keywords: critical care; intensive care unit (ICU) nurses; point‐of‐care ultrasound (POCUS); qualitative research.