Number Of Sonographers Research Articles

Sound the Alarm: The Sonographer Shortage Is Echoing Across Healthcare.

The growth in ultrasound usage necessitates concurrent growth in the number of sonographers. Despite the increasing importance of ultrasound, there is a shortage of sonographers in the United States that has never been specifically quantified. This study examines recent trends in the number of ultrasound exams, sonography graduates, open sonographer positions, and wages. This retrospective study uses public databases and surveys including the Medical Expenditure Panel Survey (MEPS), Bureau of Labor Statistics (BLS), Integrated Postsecondary Education Data System (IPEDS), and Zippia, a human resources platform to determine metrics. These metrics include the number of ultrasound exams conducted in the United States (excluding inpatient setting), number of sonographers and sonographer wages, sonography graduates, and open sonographer positions. Ultrasound exams in the United States from 2011 to 2021 increased from 38.6 million to 59.8 million (+55.1%,) while the number of sonographers (2011-2021) increased from 54,760 to 78,640 (+43.6%). There was a significant difference between supply and demand of sonographers with the number of sonography graduates (2011-2021) increasing from 4,386 to 5,393 (+23.0%) while the number of open sonographer positions (2012-2021) increased from 18,462 to 25,162 (+36.3%). From 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers. Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system. To address the shortage, the number of sonography school openings should be increased, and the attendant challenges addressed.

Retrospective analysis of 2054 cases from 24 hospitals underwent ultrasonic consultation in a tertiary prenatal diagnosis center in Beijing, China.

To investigate the practices of prenatal ultrasound consultation in a region of the China and to describe the rate of concordance between the suspected anomaly and the final diagnosis of the referral examination. Retrospective study with all cases referred from 24 hospitals (Beijing, China) to a tertiary prenatal diagnosis center for ultrasonic consultation in 2018. The concordance between the suspected ultrasonic signs of fetal abnormalities of the referrer and the ultrasonic consultation results were evaluated and divided into full concordance, partial concordance, and discordance. From 1938 patients with suspected ultrasonic signs, 2054 ultrasound consultation records were obtained. The most frequent anomalies for consultation in the first trimester (348, 91.3%) were cystic hygroma (CH), nuchal translucency (NT), or nuchal fold (NF) thickening, followed by signs of brain abnormalities in the second (173, 22.4%) and the third (182, 34.1%) trimester. The discordant rates of the first single signs were 19.8% for the first trimester, 41.6% for the second trimester, and 37.4% for the third trimester, respectively. Our study demonstrated that the discordance of the first single signs was relatively low in the first trimester and higher in the second and third trimesters. The number of sonographers could be increased to ensure timeliness, strengthen training for those with poor concordance rates by referring to appropriate guidelines, and reduce ultrasonic consultation for those with high consistency after further research to save medical resources.

Quality assurance and its impact on ovarian visualization rates in the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

ABSTRACTObjectiveTo describe the quality assurance (QA) processes and their impact on visualization of postmenopausal ovaries in the ultrasound arm of a multicenter screening trial for ovarian cancer.MethodsIn the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 50 639 women aged 50–74 years were randomized to the ultrasound arm and underwent annual transvaginal ultrasound (TVS) examinations. QA processes were developed during the course of the trial and included regular monitoring of the visualization rate (VR) of the right ovary. Non‐subjective factors identified previously as impacting on VR of the right ovary were included in a generalized estimating equation model for binary outcomes to enable comparison of observed vs adjusted VR between individual sonographers who had undertaken > 1000 scans during the trial and comparison between centers. Observed and adjusted VRs of sonographers and centers were ranked according to the highest VR. Analysis of annual VRs of sonographers and those of the included centers was undertaken.ResultsBetween June 2001 and December 2010, 48 230 of 50 639 women attended one of 13 centers for a total of 270 035 annual TVS scans. One or both ovaries were seen in 228 145 (84.5%) TVS scans. The right ovary was seen on 196 426 (72.7%) of the scans. For the 78 sonographers included in the model, the median difference between observed and adjusted VR was −0.7% (range, −7.9 to 5.9%) and the median change in VR rank after adjustment was 3 (range, 0–18). For the 13 centers, the median difference between observed and adjusted VR was −0.5% (range, −2.2 to 1%), with no change in ranking after adjustment. The median adjusted VR was 73% (interquartile range (IQR), 65–82%) for sonographers and 74.7% (IQR, 67.1–79.0%) for centers. Despite the increasing age of the women being scanned, there was a steady decrease in the number of sonographers with VR < 60% (21.4% in 2002 vs 2.0% in 2010) and an increase in sonographers with VR > 80% (14.3% in 2002 vs 40.8% in 2010). The median VR of the centers increased from 65.5% (range, 55.7–81.0%) in 2001 to 80.3% (range, 74.5–90.9%) in 2010.ConclusionsA robust QA program can improve visualization of postmenopausal ovaries and is an essential component of ultrasound‐based ovarian cancer screening trials. While VR should be adjusted for non‐subjective factors that impact on ovarian visualization, subjective factors are likely to be the largest contributors to differences in VR. © 2015 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd. on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

An investigation of sonographers unaffected by work-related musculoskeletal disorders

There is much concern amongst sonographers that reported cases of work-related musculoskeletal disorders (WRMSD) seem to be increasing at an alarming rate. Various studies have been published quoting high incidences within the profession, but there is a dearth of contemporary, robust evidence. Within the profession, anecdotal evidence suggests that a number of sonographers have been practising full-time for a number of years without experiencing any symptoms of WRMSD. In order to explore this phenomenon in more detail, a small study was undertaken looking at 22 sonographers. It was anticipated that those who have avoided the condition may offer examples of preventative strategies which could be shared within the profession. Several common themes were identified which may be protecting some of them from developing WRMSD, however, not all the findings were common to all participants. It appears that the avoidance of, as well as the development of, WRMSD is multifactorial. A high sense of personal well-being, high levels of job satisfaction and a responsive posture may be linked with avoiding WRMSD. The main learning points from this study appear to be the importance for sonographers taking responsibility for themselves, and of maintaining a constant awareness of potential problems. We recommend that, based on the experiences of our participants, sonographers experiment with different approaches at an individual level to find what works for them.

Prenatal cleft lip and palate parent programme – phase 2

In Phase 1, a protocol of care was set up for parents whose children were diagnosed prenatally with a cleft lip/palate and their responses to this protocol researched. Phase 2 looks at how, following this research, standards were developed from parents' requests and audited over eight years. Parents wanted a leaflet and referral to the cleft team when told the diagnosis. They wanted more preparation for breastfeeding, a meeting with their primary care team before the birth and they wanted the scan diagnosis to be accurate. Audit results showed that a number of sonographers were diagnosing cleft lip and palate with considerable variation in their accuracy. The audit results also highlighted a noticeable improvement in breast feeding rates and the giving of expressed breast milk (EBM) by bottle when parents were well prepared for their child's birth. It also showed that aprotocol of care that was parent-led and included parental and professi onal education positively improved parent's confidence, bonding and feeding management.

Is it possible to identify factors which affect the efficacy of screening for congenital malformations by ultrasonography?

Purpose: To assess whether the efficacy of second-trimester ultrasound screening for fetal malformations is affected by patient-, staff-, team- or work environment-related factors. Methods and design: Prospective cohort study in a Danish University hospital in 1997 and 1998. Participants: A number of 7845 pregnant women who had an ultrasound screening in weeks 18–20. Ultrasound examinations were performed abdominally by eight nurses with special training in obstetrical ultrasonography. The ultrasonographers were divided into three groups according to their experience at the start of the study. Data: A record of all malformations diagnosed by ultrasound was entered into a database. Data included the name, date of birth, body mass index of the pregnant woman, date and time of the ultrasound scan, number of persons performing the scan, name of the first and last examiner, their charge and level of expertise, number of fetuses, gestational age, structural malformation diagnosed, information about amniocentesis, date of delivery, sex of the child(ren), malformation(s) diagnosed at delivery or autopsy. Follow-up of the children was done by searching their files and by a cross-check with the diagnostic registries of the two pediatric departments in the city of Copenhagen. The length of follow-up was between 12 and 36 months. The ability to detect significant malformations on ultrasound was related to: 1 factors related to the patient (body mass index, number of fetuses, gestational age at time of screening); 2 factors related to the staff (experience of sonographer); 3 factors related to the team (number of sonographers); 4 factors related to the work environment (weekday, time of day, number of scans, work monotony, number of ultrasound screenings for malformations, and work load in the ultrasound department). Results: Significant malformations were found in 106 fetuses, when followed up at least until 1 year of age, corresponding to an incidence of 1.3%. The overall detection rate was 65.1% as 69 malformations were detected and 37 were not. No case of neural tube defect, diaphragmatic hernia, gastroschisis or omphalocele was missed. Six out of seven cases of hydrocephalus were detected, while two cases of microcephaly were not. Regarding the severe heart malformations, one out of four cases of hypoplastic left heart was detected. High maternal body mass index was associated with a lower detection rate, while the presence of twins or the gestational age at the time of screening was not. There was no correlation between the sonographer's level of experience and the detection rate. Fetuses with an undetected malformation were significantly more often scanned by more than one sonographer than fetuses without malformations. There was a trend towards a lower detection rate on Thursdays, at mid-day, when most of the staff was at work, and when the number of malformation screenings exceeded 20 per day. Conclusions: In our center, 65% of significant malformations were diagnosed, a detection rate comparable to other centers, especially since we followed the children until the age of 1 year. The detection rate of fetal heart malformations was however, low, and therefore a course with special focus on this organ was offered to the sonographers. Our study demonstrates that among the patient-related factors high maternal body mass index was the only factor associated with a lower detection rate. Among the team-related factors, malformed fetuses were significantly more often examined by two sonographers than fetuses without congenital malformations. As to the factors related to the work environment, scans performed just before lunchtime or on days when most sonographers were at work seemed to have a lower detection rate. In order to minimize error, the following changes have been made: Appointments for screening were reorganized so they are not scheduled around mid-day. A morning- and a lunch-break without any planned examinations have been scheduled in order to allow all the staff to be together at some time during the day. When an experienced sonographer requests a second opinion, a doctor should give this. The new organization will be followed up in order to secure that the reorganization has not created new organizational mistakes.

The implementation of first‐trimester scanning at 10–13 weeks' gestation and the measurement of fetal nuchal translucency thickness in two maternity units

The aim of this prospective screening study was to evaluate the implementation of an additional ultrasound examination, incorporating the measurement of fetal nuchal translucency thickness, at 10-13 weeks' gestation in two maternity units providing routine antenatal care. During the 1 year prior to the introduction of the first-trimester scan, the major indication for fetal karyotyping was maternal age > or = 35 years and only two out of the total of 11 cases of trisomy 21 were identified. In the first 5 months of the study, 70% of the women delivering in these hospitals attended for measurement of fetal nuchal translucency thickness and the measurement was obtained in all cases. This was achieved without an increase in the number of sonographers or ultrasound machines. The incidence of fetal nuchal translucency thickness > or = 2.5 mm was 3.6% (63 of 1763), and this group included three of the four fetuses with trisomy 21. The findings of this study demonstrate the feasibility of introducing scanning at 10-13 weeks' gestation and the measurement of fetal nuchal translucency thickness in routine maternity units. The sensitivity and specificity of this method of screening are at present being evaluated in a large multicenter study.

Utilization of diagnostic ultrasound in a controlled setting.

To appreciate the number of ultrasound studies of different types done within a population consisting of both rural and urban persons, a questionnaire was sent to all ultrasound facilities within the Canadian Province of British Columbia. All of the questionnaires were returned, providing complete data for 1978, 1979, and 1980. In addition to data on numbers of ultrasound studies (broken into various categories), the number of sonographers and sonologists were also analyzed. The results show an 87% increase from 1978 to 1980 in the number of studies, and, in 1980, a rate of 37 ultrasound procedures per thousand population per year (52 per thousand in the largest urban area in the province). The complete data and a discussion of the unique features of the British Columbia experience are presented.