Evaluation of training nurses to perform semi-automated three-dimensional left ventricular ejection fraction using a customised workstation-based training protocol

Guppy-Coles, Kristyan B, Prasad, Sandhir B, Smith, Kym C, Hillier, Samuel, Lo, Ada and Atherton, John J (2015) Evaluation of training nurses to perform semi-automated three-dimensional left ventricular ejection fraction using a customised workstation-based training protocol. Journal of Clinical Nursing, 24 11-12: 1479-1488. doi:10.1111/jocn.12666


Author Guppy-Coles, Kristyan B
Prasad, Sandhir B
Smith, Kym C
Hillier, Samuel
Lo, Ada
Atherton, John J
Title Evaluation of training nurses to perform semi-automated three-dimensional left ventricular ejection fraction using a customised workstation-based training protocol
Journal name Journal of Clinical Nursing   Check publisher's open access policy
ISSN 1365-2702
0962-1067
Publication date 2015-06-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/jocn.12666
Open Access Status Not yet assessed
Volume 24
Issue 11-12
Start page 1479
End page 1488
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Aims and Objectives
We aimed to determine the feasibility of training cardiac nurses to evaluate left ventricular function utilising a semi-automated, workstation-based protocol on three dimensional echocardiography images.

Background
Assessment of left ventricular function by nurses is an attractive concept. Recent developments in three dimensional echocardiography coupled with border detection assistance have reduced inter- and intra-observer variability and analysis time. This could allow abbreviated training of nurses to assess cardiac function.

Design
A comparative, diagnostic accuracy study evaluating left ventricular ejection fraction assessment utilising a semi-automated, workstation-based protocol performed by echocardiography-naïve nurses on previously acquired three dimensional echocardiography images.

Methods
Nine cardiac nurses underwent two brief lectures about cardiac anatomy, physiology and three dimensional left ventricular ejection fraction assessment, before a hands-on demonstration in 20 cases. We then selected 50 cases from our three dimensional echocardiography library based on optimal image quality with a broad range of left ventricular ejection fractions, which was quantified by two experienced sonographers and the average used as the comparator for the nurses. Nurses independently measured three dimensional left ventricular ejection fraction using the Auto lvq package with semi-automated border detection.

Results
The left ventricular ejection fraction range was 25–72% (70% with a left ventricular ejection fraction <55%). All nurses showed excellent agreement with the sonographers. Minimal intra-observer variability was noted on both short-term (same day) and long-term (>2 weeks later) retest.

Conclusions
It is feasible to train nurses to measure left ventricular ejection fraction utilising a semi-automated, workstation-based protocol on previously acquired three dimensional echocardiography images. Further study is needed to determine the feasibility of training nurses to acquire three dimensional echocardiography images on real-world patients to measure left ventricular ejection fraction.
Keyword Cardiac quantification
Echocardiography
Heart failure
Left ventricular systolic dysfunction
Nurse training
Screening
Sonographer
Three-dimensional echocardiography
Three-dimensional left ventricular ejection fraction
Workstation training
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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