title: An argument for using additional bedside tools, such as bedside ultrasound, for volume status assessment in hospitalized medical patients: a needs assessment survey.
abstract: The frequency at which housestaff need to assess volume status on medical inpatients is unknown. In this brief report, we invited 39 housestaff, over 13 randomly selected dates, to complete a 25-item survey. Participants (n = 31, 79%) logged a total of 455 hours, reporting 197 pages or telephone requests received regarding medical inpatients. Of these, 41 pages (21%) required a volume status assessment. Participants reported their volume status assessment competency to be moderate (median score = 3, interquartile range = 3 to 4, where 1 = not competent to perform independently and 6 = above average competence). In 9 of the 41 assessments (22%), at least 1 barrier was reported in determining volume status. The most commonly reported barriers were conflicting physical examination findings (n = 8, 20%) and suboptimal patient examination (n = 5, 12%). Over 20% of pages regarding admitted medical patients required volume status assessments by medical housestaff. Despite moderate self-reported competence in the ability to assess volume status, barriers such as conflicting physical examination findings and suboptimal patient examinations were present in up to 20% of assessments. Therefore, we urge educators to consider incorporating bedside ultrasound training for volume status into the internal medicine curriculum.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Low
authors.forename: Meghan
authors.initials: M
authors.lastname: Vlasschaert
authors.forename: Kerri
authors.initials: K
authors.lastname: Novak
authors.forename: Alex
authors.initials: A
authors.lastname: Chee
authors.forename: Irene W Y
authors.initials: IW
authors.lastname: Ma
mesh_terms: D000416:Alberta; D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008505:Medical Staff, Hospital; D020380:Needs Assessment; D019095:Point-of-Care Systems / Q000592:standards* / Q000706:statistics & numerical data