Abstract

The number of ambulatory and emergency department (ED) visits for skin and soft tissue infections (SSTIs) have doubled over the past two decades, accounting for more than 14 million visits annually in the United States. The two most common SSTIs, abscess and cellulitis, have a similar appearance on physical exam, creating clinical uncertainty for the treating provider. Point-of-care ultrasound (POCUS) has been identified as a valuable tool in the diagnosis of SSTIs and is superior to physical examination alone in accurately diagnosing SSTIs in both adult and pediatric patients. Moreover, the use of POCUS in patients with suspected SSTIs has shown decreased clinical failure rates compared to treatment without POCUS. Evidence-based guidelines for the treatment of abscess recommend incision and drainage (I&D), whereas cellulitis is typically treated with antibiotics. Given the differing treatment modalities, accurate diagnosis of SSTIs is essential. Misdiagnosis of SSTIs can lead to unnecessary invasive procedures, sedation, inappropriate use of antibiotics, complications, subsequent visits, inappropriate referrals, and increased healthcare costs. With limited availability of emergency nurse practitioner (ENP) academic and fellowship programs, many enter the field with little to no experience in required skills such as POCUS. Moreover, entry-level ENPs rely heavily upon on-the-job training. Although both diagnostic and procedural ultrasound are included within the practice standards of ENPs, few ENPs in the local setting identified are trained in this skill. Therefore, an educational skills workshop and tool kit are needed for ENPs to ensure competent care and provide a means of evaluation of proficiency by supporting measurable outcomes that can be utilized to evaluate ENPs use of POCUS for the diagnosis of SSTIs.

Author Details

Hilary Glover, DNP, FNP-C, ENP-C; Phyllis Fiveash, DNP, FNP-BC

Sigma Membership

Gamma Eta

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Quantitative Research

Keywords:

Point-of-Care Ultrasound, Emergency Nurse Practitioner, Skill Competence

Advisor

Bigham, Amy

Degree

DNP

Degree Grantor

Samford University

Degree Year

2020

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2020-07-17

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