Factors influencing sonographer-led bowel ultrasound service

ABSTRACT

The aim of this study was to investigate factors influencing UK sonographers' practice of adult bowel ultrasound. A mixed-method online questionnaire was designed and shared on social media platforms in April 2021. Research restrictions due to COVID19 limited the sample size permitted. Convenience sampling recruited thirty UK sonographers performing adult abdominal ultrasound in their practice. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using inductive thematic analysis. Quantitative data revealed that 53% (n= 16) of the participants expressed a lack of confidence in scanning the bowel, while 77%, (n = 23) indicated a high level of interest in training in bowel ultrasound. Although 63.3% (n = 19) of the participants reported a high level of confidence in scanning the bowel for suspected appendicitis, the majority (70%, n = 21) expressed lack of confidence in examining the bowel for other pathologies like inflammatory bowel disease (IBD). Inductive thematic analysis of qualitative data revealed that the participants had varying opinions on this topic. Emerging themes included training opportunities, preference of other imaging modalities, management challenges, sonographers, and radiologists' influence. Qualitative results suggested that factors influencing sonographer evaluation of the bowel include advanced levels of training, a high degree of support from radiologists, regular bowel ultrasound lists, audits, and feedback from clinicians. Based on the findings of this study, most sonographers are not confident in practising bowel ultrasound beyond the evaluation of suspected appendicitis. Surveyed sonographers were interested in expanding their roles into other areas of bowel ultrasound like examining for Crohn's and ulcerative colitis. Sonographer role extension into this area of practice is limited by various factors like chronic shortage of sonographers, increasing workload, limited training, and the perception of diminishing support from radiologists. We recommend a future study that is not limited by a small sample size.