SESSION TITLE: Radiology Done by the Nonradiologist SESSION TYPE: Original Investigations PRESENTED ON: 10/23/2019 10:45 AM - 11:45 AM PURPOSE: Pneumothorax (PTX) following flexible bronchoscopy with transbronchial biopsy occurs in up to 4% of cases. Chest radiograph (CXR) remains the standard for detecting post-procedure PTX but delays in performing and interpreting the CXR adds to both patient turn-over time and costs. Lung ultrasound (LUS) has superior sensitivity for ruling out PTX, and has been performed by nurses in prior studies. We explored nursing perspectives regarding the feasibility and desirability of a nurse-driven protocol using LUS to rule out PTX following transbronchial biopsy, to thereby increase diagnostic accuracy and decrease radiation exposure and post-procedural wait-time. METHODS: An anonymous, self-administered survey was developed and given to post-anesthesia care unit (PACU) nurses at a tertiary care lung transplant center during a one-month period. Primary outcomes were nursing perceptions of the time to post-procedural CXR and radiology read as a cause of delay for patient discharge and the feasibility of a nurse-driven LUS protocol. RESULTS: 37 nurses completed the survey, with 36 (97%) identifying the post-procedural CXR or the radiology read as one of the top 3 causes of delay for discharge from the PACU. The next most common was awaiting physician sign off (43%). 86% felt that the delay was greater than 45 minutes. 62% were interested in learning LUS to rule out pneumothorax, but only 40% would be comfortable if the discharge was based solely on their interpretation. However, nurses that were more experienced (p=0.036) or more comfortable with technology (p=0.030) were more likely to feel comfortable performing a scan and interpreting it themselves. Having a physician interpret the examination increased confidence significantly (76%, p<0.001). CONCLUSIONS: PACU nurses believe that CXR is a source of delay in disposition after lung biopsy. The majority would be interested in learning to perform LUS but would be more comfortable if a physician interpreted the images. CLINICAL IMPLICATIONS: A program to decrease length of stay in the PACU should target delays in radiology interpretation. LUS is an attractive target, but PACU nurses are concerned about a program that does not include physician interpretation of images. This information will inform the creation of a curriculum to train select PACU nurses in the use of LUS to evaluate for pneumothorax. DISCLOSURES: No relevant relationships by Cameron Baston, source=Web Response no disclosure on file for Christoph Hutchinson; No relevant relationships by Ryan Sullivan, source=Web Response