Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study
Objective Preprocedure pleural fluid localization using bedside ultrasound has been shown to reduce complications related to thoracentesis and is now considered the standard of care. However, ultrasound-guided thoracentesis (USGT) has not been broadly adopted in many low-resource settings. With incr...
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| Format: | Article |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/12/e064638.full |
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| author | Jennifer Doran Reem Hanna Tatenda Nyagura-Mangori Narayan Mahotra Santa Kumar Das Magaret Borok Ali Musani Anna M Maw |
| author_facet | Jennifer Doran Reem Hanna Tatenda Nyagura-Mangori Narayan Mahotra Santa Kumar Das Magaret Borok Ali Musani Anna M Maw |
| author_sort | Jennifer Doran |
| collection | DOAJ |
| description | Objective Preprocedure pleural fluid localization using bedside ultrasound has been shown to reduce complications related to thoracentesis and is now considered the standard of care. However, ultrasound-guided thoracentesis (USGT) has not been broadly adopted in many low-resource settings. With increasing affordability and portability of ultrasound equipment, barriers to USGT are changing. The aim of this multisite qualitative study is to understand the current barriers to USGT in two resource-limited settings.Setting We studied two geographically diverse settings, Harare, Zimbabwe, and Kathmandu, Nepal.Participants 19 multilevel stakeholders including clinical trainees, attendings, clinical educators and hospital administrators were interviewed. There were no exclusion criteria.Primary outcome To understand the current determinants of USGT adoption in these settings.Results Three main themes emerged from these interviews: (1) stakeholders perceived multiple advantages of USGT, (2) access to equipment and training were perceived as limited and (3) while an online training approach is feasible, stakeholders expressed scepticism that this was an appropriate modality for procedural training.Conclusion Our data suggests that USGT implementation is desired by local stakeholders and that the development of an educational intervention, cocreated with local stakeholders, should be explored to ensure optimal contextual fit. |
| format | Article |
| id | doaj-art-81d5dbeb74a9473f9e8a08b843bd89ba |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-81d5dbeb74a9473f9e8a08b843bd89ba2025-08-20T02:57:02ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-064638Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative studyJennifer Doran0Reem Hanna1Tatenda Nyagura-Mangori2Narayan Mahotra3Santa Kumar Das4Magaret Borok5Ali Musani6Anna M Maw7Department of Medicine, University of Colorado Hospital, Aurora, Colorado, USADivision of Hospital Medicine, University of Colorado, Aurora, Colorado, USADepartment of Medicine, Harare University Teaching Hospital, Harare, ZimbabweDivision of Physiology, Tribhuvan University Institute of Medicine, Maharajgunj, NepalDivision of Pulmonary and Critical Care Medicine, Tribhuvan University Teaching Hospital, Kathmandu, NepalUnit of Internal Medicine, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, ZimbabweDivision of Pulmonary and Critical Care Medicine, University of Colorado, Aurora, Colorado, USADivision of Hospital Medicine, University of Colorado, Aurora, Colorado, USAObjective Preprocedure pleural fluid localization using bedside ultrasound has been shown to reduce complications related to thoracentesis and is now considered the standard of care. However, ultrasound-guided thoracentesis (USGT) has not been broadly adopted in many low-resource settings. With increasing affordability and portability of ultrasound equipment, barriers to USGT are changing. The aim of this multisite qualitative study is to understand the current barriers to USGT in two resource-limited settings.Setting We studied two geographically diverse settings, Harare, Zimbabwe, and Kathmandu, Nepal.Participants 19 multilevel stakeholders including clinical trainees, attendings, clinical educators and hospital administrators were interviewed. There were no exclusion criteria.Primary outcome To understand the current determinants of USGT adoption in these settings.Results Three main themes emerged from these interviews: (1) stakeholders perceived multiple advantages of USGT, (2) access to equipment and training were perceived as limited and (3) while an online training approach is feasible, stakeholders expressed scepticism that this was an appropriate modality for procedural training.Conclusion Our data suggests that USGT implementation is desired by local stakeholders and that the development of an educational intervention, cocreated with local stakeholders, should be explored to ensure optimal contextual fit.https://bmjopen.bmj.com/content/12/12/e064638.full |
| spellingShingle | Jennifer Doran Reem Hanna Tatenda Nyagura-Mangori Narayan Mahotra Santa Kumar Das Magaret Borok Ali Musani Anna M Maw Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study BMJ Open |
| title | Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study |
| title_full | Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study |
| title_fullStr | Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study |
| title_full_unstemmed | Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study |
| title_short | Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study |
| title_sort | stakeholder perspectives on current determinants of ultrasound guided thoracentesis in resource limited settings a qualitative study |
| url | https://bmjopen.bmj.com/content/12/12/e064638.full |
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