Point of care ultrasound in Inflammatory Bowel Disease patients, being introduced in an Irish context - key stakeholder's perspectives

Background
Point of care ultrasound is a real-time, non-invasive imaging modality used across many disciplines for several years, including in Inflammatory Bowel Disease (IBD) patients in central Europe. However, it is only recently beginning to be introduced in an Irish context. This study aims to explore the perspectives of key stakeholders in IBD in Ireland, towards the introduction of point of care ultrasound (PoCUS) amongst IBD patients. The secondary aim is to clarify if key stakeholders are supportive of nurse performed PoCUS in IBD if a referral pathway was to become available in an Irish context.

Methods
A quantitative cross sectional, descriptive online survey was developed to collect anonymous responses from key stakeholders in the IBD clinical care context in Ireland. The email inviting potential respondents to consider participation in the survey was distributed by two professional bodies – The Irish Society of Gastroenterology and Inflammatory Bowel Disease Nurses Association of Ireland. Analysis included a descriptive modelling of the data using logistic regression.

Results
In completing the survey, 25% of respondents confirmed that they had an ultrasound service for IBD patients while 44% (n=42) have future plans to develop one. Among the surveyed doctors, only 9% (n=9) have undergone training in PoCUS, while 79% of all respondents express intentions to pursue training or are open to considering it in the future. On average, respondents disagreed that PoCUS will replace Colonoscopy and MRI in the future, with a mean score of 2.47 (SD 1.24). Doctors and nurses perceive having access to PoCUS as important for patient outcome and quality of care, mean 4.06 (SD 1.02). Overall, 51% (n=48) of respondents reported having no fears or reservations associated with using PoCUS in clinical practice. Both doctors and nurses exhibited positive attitudes towards nurse-led PoCUS in IBD, highlighting its perceived cost effectiveness, as evidenced by a mean score of 4.38 (SD 1.01).

Conclusion
Key findings highlight a majority of respondents have plans to develop a PoCUS service and undertake training to improve quality of care for patients with IBD. The vast majority of respondents support the introduction of nurse performed PoCUS in the Irish setting.