Health Care Provider Satisfaction Research Articles

Profiles About Practice Settings of American College of Obstetricians and Gynecologists Fellows

Selection of a practice setting affects duty hours, practice autonomy, institutional relationships, administrative responsibilities, personal finances, and professional satisfaction. To identify national trends in practice settings reported by the College, we evaluated responses by Fellows (and Junior Fellows) in active practice from six College surveys on professional liability issues between 1992 and 2012. Although half of Fellows remained in an independent private practice, a decline was observed among solo health care practitioners (from 32% in 1992 to 19% in 2012). Direct employment increased either in hospital systems (from 5% to 15%) or as academic faculty (from 9% to 12%). The proportion of Fellows employed by either health maintenance organizations (from 4% to 2%) or the government (2%) remained low. We anticipate that practice settings will be increasingly influenced by health care reform, team-based care with use of nonphysician clinicians, physician age, and increasing subspecialization. Future surveys of Fellows about their practice settings, preferably required at the time of Maintenance of Certification, will aid in evaluating practice settings and their influence on quality of care, cost containment, and health care provider satisfaction.

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Introduction: Effective and efficient formal daily rounds are essential for patient care in any hospital setting. They allow for a clear exchange of information and formulation of a daily care plan. Family centeredness is a significant component in this commitment. Communication between families and multidisciplinary health care providers can be improved efficiently and adherence to best practice recommendations promoted by utilizing structured family centeredness. Methods: A structured standardized rounds policy was developed with well defined roles for each provider and provision of family participation. A quality improvement project utilizing a series of PDSA cycles was utilized to assess its effectiveness and monitor progress. To ensure that the process unfolds reliably and consistently, compliance was audited by daily review of the nursing presentation script. Deficiencies/obstacles were discussed/rectified in monthly team meetings. Results: Four Plan (P), Do (D), Study (S) and Act (A) cycles were conducted as following: Cycle 1: (P) Identify barriers. (D) Stakeholder survey (n=135). (S) Total response rate 53% with 70% preferring bedside rounding. Concerns included coordinating rounds with consulting services (22%) and distraction factors (19%). (A) A structured rounding policy was developed with resident and nursing presentation template. Cycle 2: (P) Observe compliance. (D) Script analyzed (n=322). (S) Completion rate 81%, family presence 37%, RT presence 22%. (A) Blueprint modification for easier data entry and extraction. Participation barriers identified and removed. Cycle 3: (P) Monitor patient care bundles. (D) Template incorporation (n=156). (A) Need for central line completed 85%, extubation readiness 78%, urinary catheter need 94%. (A) Integrate bundle elements. Cycle 4: (P) Add daily goal checklist. (D) Describe goal section. (S) Compliance of daily goals being monitored. Conclusions: These results demonstrate that a continuous PDSA cycle is an efficient technique adaptable to complex systems with multiple stake holders. Continuous quantitative and qualitative assessments of family and healthcare provider satisfaction along with patient care guidelines compliance (CLABSI, VAP and CAUTI bundles) can be effectively monitored utilizing such techniques.

Commentaries on health services research

Box 1Studies such as this build upon an important body of literature to document what PAs and NPs do and how they do it in teams. Robust analyses of large sample sizes with a range of acuity and chronicity of disease are needed to measure the contribution of PAs and NPs and advance the concept of the patient-centered medical home approach to care. The authors have succeeded and set the stage for future research in differentiating various levels of team-based care. These findings reveal an interesting number of statistically significant differences in PA and NP panel complexity when compared to physician-only panels. For example, PAs and NPs saw fewer white patients; a greater proportion of patients with disabilities; and more with Medicaid buy-in, dementia, obesity, drug abuse, depression, or diabetic ulcers. These results were consistent with other research confirming the PA and NP contributions to underserved populations with indicators of social complexity. The three most significant panel differences were among patients with Medicare or Medicaid disability entitlement, dementia, and depression, confirming vital roles for PAs and NPs in providing supplemental mental health and care coordination services. Commentary by P. Eugene JonesBox 2If the founders of the PA and NP professions were to read this article, they would be pleased with the results; PAs and NPs are fulfilling their vision by providing quality care to patients who lack access to healthcare, thus permitting physicians to spend more clinical time focused on complicated patients. They would be encouraged to know that PAs and NPs are still providing a high proportion of the care provided to patients in rural areas. The strategy of extending physician services through collaborative care has been realized, with physicians providing more care to patients over 45 years old, and PAs and NPs seeing presumably less-complicated younger patients. A trend has emerged as well: PAs and NPs are providing 61% more clinical services in the nation's hospital outpatient departments as of 2010 than they were in 2001, and are responsible for more than 1.3 million patient visits annually. Such findings underscore how matching a workforce solution to a societal problem continues to be handled. Commentary by Tamara RitsemaBox 3The question of career satisfaction of healthcare providers is an important one. Decreasing satisfaction could lead to fewer high-quality applicants seeking to become PAs, as well as increasing attrition of those already in the profession, both which would be troublesome in an era of health professional shortages. The assumption is that high career satisfaction attracts highly qualified and talented individuals to become PAs. This study addresses the issue of PA career contentment in light of the observation that the profession has substantially feminized, and tries to measure whether lifestyle-career conflicts affect the career satisfaction of women. There are some troubling issues with the author's assertions. Historically, Marvelle and LaBarbera each investigated PA career satisfaction.1,2 The specific issue of gender salary discrepancies in the PA profession was reported by Carter in 1983 and Coplan in 2012; both reported that men's salaries were higher than women's.3,4 Although all of these preceded publication of this study, only LaBarbera is referenced. Biscardi and colleagues also assert that the feminization of the profession is a recent phenomenon—which is not supported by their data. In fact the 27th PAEA Annual Report shows that first-year PA student enrollments of about 60% women occurred in 1983 and continued through to 1999, before gradually rising to the 2010 rate of 72.5%.5 Although this study investigates important issues, it also suffers from methodologic problems. The data are not current, having been collected in 2008, and the response rate of 11% is very low for a national cross-sectional survey, so should not be presented as reflecting the population at large. This, combined with the fact that the respondent population (53% women) differs substantially in gender distribution from the population of certified PAs (64% women in 2011), indicates that the findings of this study are not generalizable to all PAs.6 Although the questions investigated in this study are important, additional research using higher response rates is needed before conclusions about the PA profession can be stated categorically. Commentary by Richard W. Dehn

Music to Reduce Pain and Distress in the Pediatric Emergency Department

Many medical procedures aimed at helping children cause them pain and distress, which can have long-lasting negative effects. Music is a form of distraction that may alleviate some of the pain and distress experienced by children while undergoing medical procedures. To compare music with standard care to manage pain and distress. Randomized clinical trial conducted in a pediatric emergency department with appropriate sequence generation and adequate allocation concealment from January 1, 2009, to March 31, 2010. Individuals assessing the primary outcome were blind to treatment allocation. A total of 42 children aged 3 to 11 years undergoing intravenous placement were included. Music (recordings selected by a music therapist via ambient speakers) vs standard care. The primary outcome was behavioral distress assessed blinded using the Observational Scale of Behavioral Distress-Revised. The secondary outcomes included child-reported pain, heart rate, parent and health care provider satisfaction, ease of performing the procedure, and parental anxiety. With or without controlling for potential confounders, we found no significant difference in the change in behavioral distress from before the procedure to immediately after the procedure. When children who had no distress during the procedure were removed from the analysis, there was a significantly less increase in distress for the music group (standard care group = 2.2 vs music group = 1.1, P < .05). Pain scores among children in the standard care group increased by 2 points, while they remained the same in the music group (P = .04); the difference was considered clinically important. The pattern of parent satisfaction with the management of children's pain was different between groups, although not statistically significant (P = .07). Health care providers reported that it was easier to perform the procedure for children in the music group (76% very easy) vs the standard care group (38% very easy) (P = .03). Health care providers were more satisfied with the intravenous placement in the music group (86% very satisfied) compared with the standard care group (48%) (P = .02). Music may have a positive impact on pain and distress for children undergoing intravenous placement. Benefits were also observed for the parents and health care providers. clinicaltrials.gov Identifier: NCT00761033.

The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes

PurposeWhile contributing to an improved continuity of care, Shared Electronic Health Record (EHR) systems may also lead to information overload of healthcare providers. Document-oriented architectures, such as the commonly employed IHE XDS profile, which only support information retrieval at the level of documents, are particularly susceptible for this problem. The objective of the EHR-ARCHE project was to develop a methodology and a prototype to efficiently satisfy healthcare providers’ information needs when accessing a patient's Shared EHR during a treatment situation. We especially aimed to investigate whether this objective can be reached by integrating EHR Archetypes into an IHE XDS environment. MethodsUsing methodical triangulation, we first analysed the information needs of healthcare providers, focusing on the treatment of diabetes patients as an exemplary application domain. We then designed ISO/EN 13606 Archetypes covering the identified information needs. To support a content-based search for fine-grained information items within EHR documents, we extended the IHE XDS environment with two additional actors. Finally, we conducted a formative and summative evaluation of our approach within a controlled study. ResultsWe identified 446 frequently needed diabetes-specific information items, representing typical information needs of healthcare providers. We then created 128 Archetypes and 120 EHR documents for two fictive patients. All seven diabetes experts, who evaluated our approach, preferred the content-based search to a conventional XDS search. Success rates of finding relevant information was higher for the content-based search (100% versus 80%) and the latter was also more time-efficient (8–14min versus 20min or more). ConclusionsOur results show that for an efficient satisfaction of health care providers’ information needs, a content-based search that rests upon the integration of Archetypes into an IHE XDS-based Shared EHR system is superior to a conventional metadata-based XDS search.

Health Care Provider Satisfaction With a New Electronic Progress Note Format: SOAP vs APSO Format

Health Care Provider Satisfaction With a New Electronic Progress Note Format: SOAP vs APSO Format

Satisfaction of health care professionals managing patients with inflammatory bowel disease

Background and aimsThe aim of the present study was to analyze the satisfaction of health care professionals who attend patients with inflammatory bowel disease (IBD) and to determine the variables more related with satisfaction/dissatisfaction. MethodsCross-sectional, self-administered written 15-item questionnaire was evaluated using a Likert scale, completed by Spanish gastroenterologists and nurse practitioners specialized in IBD patient care. ResultsA total of 202 surveys, 133 physicians (65.8%) and 69 nurses (34.2%) were conducted. Global scoring of satisfaction was 54.0 for physicians and 64.2 for nurses (p<0.001). In both groups the highest scores were achieved in those items related to their professional careers and management of personal and professional lives as well as those that refer to their interdisciplinary relationship with other medical units, management of patients within the hospital setting and finally communication with the patient. The items that attained the lowest score included those related to the length and staff available for the medical consult, work environment and the balance among health care provider needs for contribution, recognition and fulfillment. With regard to the variables involved with satisfaction, the results show that those physicians that only took care of IBD patients achieved a higher degree of satisfaction. This could be related with the fulfillment of their own professional expectations. ConclusionsThe level of satisfaction of health care professionals that take care of IBD patients is low and may impact on patient care. Therefore, new strategies to increase the degree of satisfaction of IBD health care providers should be implemented.

Assessing a nephrology-focused YouTube channel’s potential to educate health care providers

YouTube has emerged as a potential teaching tool. Studies of the teaching potential of YouTube videos have not addressed health care provider (HCP) satisfaction; a necessary prerequisite for any teaching tool. We conducted a 4-month investigation to determine HCP satisfaction with a nephrology-specific YouTube channel. The Nephrology On-Demand YouTube channel was analyzed from January 1 through April 30, 2011. Sixty-minute nephrology lectures at East Carolina University were compressed into 10-minute videos and uploaded to the channel. HCPs were asked to answer a 5-point Likert questionnaire regarding the accuracy, currency, objectivity and usefulness of the digital format of the teaching videos. Means, standard deviations and 2-sided chi-square testing were performed to analyze responses. Over 80% of HCPs considered the YouTube channel to be accurate, current and objective. A similar percentage considered the digital format useful despite the compression of videos and lack of audio. The nephrology-specific YouTube channel has the potential to educate HCPs of various training backgrounds. Additional studies are required to determine if such specialty-specific channels can improve knowledge acquisition and retention.

Evaluation of a transplantation specialty pharmacy program

The value of a transplantation specialty pharmacy (TSP) program, including its impact on patient and health care provider satisfaction, selected clinical outcomes, and the institution's financial margin, was evaluated. Patient and health care provider surveys were distributed to evaluate satisfaction with the TSP program. Medication adherence (using continuous measures of medication adherence), hospital readmissions within 90 days of transplantation, and length of hospitalization were examined. Patients enrolled in the TSP program who received kidney transplants between July 1, 2009, and June 30, 2010, were included. Patients who received kidney transplants at the institution between July 1, 2007, and June 30, 2008, served as the control group. Of the 838 patient surveys distributed, 290 (34.6%) were returned. Most patients (84%) reported being satisfied with the program, and 98% would recommend it to others. Ninety-six percent of providers believed the pharmacy improved continuity of care, and 91% reported spending less time on pharmacy-related problems after the program's initiation. Medication adherence appeared to be higher in patients enrolled in the TSP program compared with historical controls. Hospital readmissions and length of stay did not significantly differ between groups. The TSP program generated $7.5 million in revenue during its first fiscal year. Roughly $5.5 million was spent on incremental operating expenses, resulting in over $2 million in margin. A TSP program provided a high level of satisfaction to patients and health care providers, may have influenced some clinical outcomes, and served as a source of positive margin for its institution.

Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso

In 2004, a community-based health insurance (CBI) scheme was introduced in Nouna district, Burkina Faso, with the primary objective of improving access to facility-based health services. In order to overcome self-selection issues in the analysis of the behavioral effects of insurance, we combine four waves of the Nouna Health District Household Survey into a panel data set, and use the randomized timing of insurance rollout to estimate the causal effect of insurance coverage on health-seeking behavior. While we find a generally positive association between CBI affiliation and treatment seeking, we cannot reject the null that the introduction of health insurance does not have any effect on treatment seeking in general, and utilization of facility-based professional care, in particular. Low levels of health care provider satisfaction, poor perceived quality of care by enrollees, and ambiguity in the coverage level of the CBI benefit package appear to have contributed to these weak results. Our findings imply that the basic notion of insurance mechanically increasing facility-based professional care is not necessarily true empirically, and likely contingent on a large number of contextual factors affecting health-seeking behavior within households and communities.

Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

PurposeTo evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.MethodsPeople with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.ResultsA total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.)ConclusionThe quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes.

Health Care Provider Satisfaction with Telephone Consultations Provided by Pharmacists and Physicians at the National HIV/AIDS Clinicians’ Consultation Center

The federally funded National HIV/AIDS Clinicians' Consultation Center (NCCC) offers US health care providers expert telephone consultations for managing HIV/AIDS and occupational exposures to blood-borne pathogens through 3 telephone services: the National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline), the National HIV Telephone Consultation Service (Warmline), and the Perinatal HIV Hotline. Callers to the NCCC receive consultation from either a clinical pharmacist (PharmD) or a physician (MD) with HIV expertise. To compare the satisfaction of NCCC callers who received clinical consultations from clinical pharmacists and physicians with HIV expertise. We prospectively mailed 1256 satisfaction surveys to NCCC health care provider callers during a 7-month period. Survey recipients were not aware that satisfaction surveys compared PharmD and MD consultation services. Respondents rated their level of agreement with 8 statements about the quality of consultation, the quality of clinical information given, and future calls to the NCCC. Survey return rates were 43% for PEPline and 40% for Warmline and Perinatal HIV Hotline combined. Overall, caller satisfaction with the telephone consultation service was extremely high (>4 in all categories on a 1-5 Likert scale). There was no significant difference in PEPline caller satisfaction ratings between PharmD and MD consultations. Callers to the Warmline and Perinatal HIV Hotline agreed with all 8 satisfaction statements. For the following 3 statements, however, satisfaction was higher when Warmline and Perinatal HIV Hotline consultation was provided by an MD: "Overall, I was pleased with the quality of my consultation" (p = 0.04); "I would use this service again" (p < 0.02); and "I am likely to recommend this service to my colleagues" (p = 0.02). Health care provider callers to the NCCC were highly satisfied with the information obtained from this HIV/AIDS telephone consultation service. By measuring callers' survey response to PharmD and MD consultations, the importance of the clinicians' contributions to this advanced HIV/AIDS consultation service is documented.

Palliative noninvasive ventilation in patients with acute respiratory failure

Over the last two decades, the increasing use of noninvasive ventilation (NIV) has diminished the need for endotracheal ventilation, thus decreasing the rate of ventilation-induced complications. Thus, NIV has decreased both intubation rates and mortality rates in specific subsets of patients with acute respiratory failure (e.g., patients with hypercapnia, cardiogenic pulmonary edema, immune deficiencies, or post-transplantation acute respiratory failure). NIV is also increasingly used as a palliative strategy when endotracheal ventilation is deemed inappropriate. In this context, palliative NIV can either be administered to offer a chance for survival, or to alleviate the symptoms of respiratory distress in dying patients. The literature provides information from 10 studies published between 1992 and 2006, in which 458 patients received palliative NIV. The technique was feasible, usually well tolerated, and half of the patients survived. The objectives of this review article are to define palliative NIV, to delineate the place for palliative NIV among overall indications of NIV, and to define the contribution of NIV to the palliative strategies available for patients with acute respiratory failure. Potential benefits and harm from NIV in patients who are not eligible for endotracheal ventilation are discussed. The appropriateness of palliative NIV should be reported in a study that relies on both quantitative criteria (rate of palliative NIV use and mortality) and qualitative criteria (patient comfort, end-of-life process, family burden, and health-care provider satisfaction).

Balanced propofol sedation for therapeutic GI endoscopic procedures: a prospective, randomized study

There are few controlled studies on balanced propofol sedation (BPS) for therapeutic endoscopy. To compare the safety and efficacy of BPS (propofol in combination with midazolam and meperidine) with conventional sedation (midazolam and meperidine) in patients undergoing therapeutic endoscopic procedures. Prospective, randomized, single-blinded study. Tertiary-care referral center. This study involved 222 consecutive patients undergoing therapeutic EGD or ERCP from July 2009 to March 2010. Conventional sedation or BPS by trained registered nurses under endoscopist supervision. Rates of sedation-related cardiopulmonary complications and interruption of the procedures, procedure-related times, and assessments of health care providers (endoscopists and sedation nurses) and patients. There were no significant differences between the BPS and conventional groups in the rates of cardiopulmonary complications (8.8% [9/102] vs 5.8% [6/104], respectively) and transient interruption of procedures (2.9% [3/102] vs 0% [0/104], respectively). No patient required assisted ventilation or premature termination of a procedure. BPS provided significantly higher health care provider satisfaction (mean±SD 10-cm visual analog scale [VAS] score) compared with conventional sedation (endoscopists: 7.57±2.61 vs 6.55±2.99, respectively; P=.011; sedation nurses: 7.86±2.31 vs 6.67±2.90, respectively; P=.001). Patient cooperation was significantly better in the BPS group (VAS; endoscopists: 7.24±2.97 vs 6.27±3.09, P=.024; sedation nurses: 7.75±2.30 vs 6.54±2.99, P=.001). Single-center and single-blinded study. Compared with conventional sedation, BPS provides higher health care provider satisfaction, better patient cooperation, and similar adverse event profiles in patients undergoing therapeutic endoscopic procedures.

Are patients and healthcare providers satisfied with health sector reform implemented in family health centres?

BackgroundPatients' and healthcare providers' satisfactions are important outcomes for any healthcare programmes. In Egypt, the Health Sector Reform Program (HSRP) has been implemented since 1999 in primary healthcare (PHC) centres...

Clinical Safety and Efficacy of a Novel Thermoreversible Polyhexanide-Preserved Wound Covering Gel

Background: An ideal topical formulation for wound therapy does not exist. The aim of this study was to develop a novel improved therapeutic option for the treatment of acute and chronic wounds. Methods: A transparent wound gel which is in a liquid state below and in a gel state at or above room temperature was developed. Forty-four patients were included in this open randomized controlled single-center study. Flammazine™ served as control in the treatment of skin graft donor sites. Wounds were assessed for time of dressing change and overall satisfaction of patients and health care providers. The data were analyzed using the nonparametric Mann-Whitney test. Results: The wound gel proved to be superior in comparison with Flammazine with respect to wound assessment (p = 0.002), staining (p = 0.007), leaking (p = 0.032) and smell (p = 0.034). Flammazine showed favorable results regarding the parameters dehydration of the dressings (p = 0.012) and wound adherence (p = 0.005). The evaluation of the overall dressing change process showed no significant differences. Conclusion: The thermoreversible wound gel containing polyhexanide allows for good handling and wound assessment. This study demonstrated a high satisfaction level of patient and health care providers, and the wound gel proved an effective alternative to commonly used treatments.

Using patient-reported outcomes in clinical practice: proceedings of an International Society of Quality of Life Research conference

In recent years there has been growing interest in the use of patient-reported outcomes (PROs) in daily clinical practice as an aid in detecting physical and psychosocial problems that might otherwise be overlooked, to monitor disease and treatment effects, to improve the quality of care, and ultimately to enhance the health and well-being of patients. The provision of timely, systematic information derived directly from patients about their physical and psychosocial health has been demonstrated to have a salutary effect, to a greater or lesser degree, on a cascade of outcomes including, from most proximal to most distal: patient– health care provider communication; provider awareness of patients’ health problems, patient management (e.g., referral patterns, medication prescription, counseling, etc.), patient and health care provider satisfaction, and patients’ health-related quality of life over time. The development of increasingly flexible and efficient assessment systems based on modern test theory and the emergence of sophisticated, user-friendly data capture systems (e.g., touch screen computers, interactive voice response telephone interviews, web-based surveys, etc.) facilitate the adoption of PROs in the clinical practice setting. In recognition of this relatively new and potentially fruitful area of PRO application, the International Society for Quality of Life Research organized an international conference in Budapest, Hungary on June 24–26, 2007. This three-day conference was intended to: summarize the state-of-the-art of PRO assessment in daily clinical practice; identify gaps in our knowledge base (theoretical, empirical, and experiential) with regard to using PROs in clinical practice; develop a research agenda for improving the science and practicality of PRO assessment in clinical practice; and involve various stakeholders in the discussion of PROs in clinical practice. The conference began with a half-day program of workshops, followed by two days of plenary sessions and proffered poster sessions. For each plenary session, there were two invited speakers. The major topic areas addressed during the conference included: (1) theoretical underpinnings for using PROs in clinical practice; (2) applications of PROs in clinical practice; (3) content of PROs in clinical practice; (4) logistics of collecting PROs in clinical practice; (5) training health care professionals to use and interpret data from PROs in clinical practice; and (6) evaluating the effectiveness of PROs in clinical practice. A series of papers has been generated from this conference, four of which are published in the current issue of Quality of Life Research, with the remaining four scheduled for publication in early 2009. We hope that, taken together, these papers will provide both an overview of the state-of-the-art of PRO assessment in clinical practice and an agenda for future PRO research and applications in this setting. On behalf of the members of the conference planning committee (Michael Brundage, David Osoba, Galina Velikova, Albert Wu, and Susan Yount),

Caregiver and Health Care Provider Satisfaction with Volumetric Bladder Ultrasound

Conventional (nonimaged) bladder catheterization has lower first-attempt success rates (67%-72%) when compared with catheterization aided by volumetric bladder ultrasonography (US) (92%-100%), yet the total time to urine sample collection with US can be quite lengthy. Given the advantage and disadvantages, the authors assessed caregiver and health care provider satisfaction with these two methods. Caregivers and health care providers of children enrolled in a prospective, randomized, controlled trial examining the first-attempt urine collection success rates with these two methods completed standardized questionnaires. Each child's caregiver, nurse, and physician noted their perceptions, satisfaction, and future preferences using Likert-scale assessments. Of 93 caregivers, 45 had children randomized to the conventional arm and 48 to the US arm. Nine physicians and three nurses participated. Both caregiver groups had similar previous catheterization experience; none had children undergo volumetric bladder sonography. Caregivers in the conventional group rated their children's discomfort higher (4.4 vs. 3.4; p = 0.02) and were less satisfied (4.5 vs. 6.4; p < 0.0001) than those in the US group. Nurses' satisfaction with catheterization in the conventional group was lower than in the US group (3.0 vs. 5.5), as was physicians' satisfaction (4.3 vs. 5.7; p < 0.0001). Both nurses and physicians indicated that they would be less likely to use conventional catheterization in future attempts. Caregivers in the conventional group rated their children's discomfort higher than did caregivers in the US group. Both caregivers and health care providers expressed greater satisfaction with US and were more likely to prefer this imaging modality with future catheterization attempts.

Caregiver and Health Care Provider Satisfaction with Volumetric Bladder Ultrasound

Caregiver and Health Care Provider Satisfaction with Volumetric Bladder Ultrasound

Caregiver and Healthcare Provider Satisfaction with Ultrasound-Guided Pediatric Bladder Catheterization

Caregiver and Healthcare Provider Satisfaction with Ultrasound-Guided Pediatric Bladder Catheterization