title: Use of ultrasound by registered nurses-a systematic literature review.
abstract: BACKGROUND
  In Western Australia (WA), most stable patients undergoing haemodialysis receive treatment in a satellite setting where no doctors are on-site during treatment hours, so nurses must make critical decisions about fluid removal. Some patients regularly experience adverse events during dialysis (intradialytic), often due to excessive ultrafiltration goals, with intradialytic hypotension being particularly challenging. Ultrasound of the inferior vena cava has been previously demonstrated being a rapid and non-invasive method for volume assessment on haemodialysis patients, thus could hold valuable information for the treating nurse.
  
  
  OBJECTIVE
  This paper examines the existing literature in regards to the use of ultrasound measurements of the inferior vena cava in patients on haemodialysis for objective assessment of their intravascular volume status by renal nurses.
  
  
  METHODS
  A systematic literature review was performed within medical and nursing databases including CINAHL Plus with Full Text, SCOPUS, Web of Science and MEDLINE.
  
  
  RESULTS
  Renal nurses are conscious of the significance of intradialytic hypotension and have only limited options for its prevention. Ultrasound of the inferior vena cava could add another objective dimension for intravascular volume assessment and prevention of intradialytic hypotension, but to date renal nurses have not been using this technique.
  
  
  CONCLUSIONS
  Ultrasound of the inferior vena cava has the potential to assist in defining the ultrafiltration goal for that particular dialysis session, thus reducing the risk of intradialytic hypotension. Additionally, it has potential to change current renal nursing practice when added to clinical nursing assessment methods. Further studies are required to validate this assessment tool carried out by a renal nurse compared with a skilled ultrasonographer.
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinwandel
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Gibson
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, QEII Medical Centre, Nedlands, Western Australia, Australia.
authors.forename: James Charles
authors.initials: JC
authors.lastname: Rippey
authors.affiliation: School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Towell
authors.affiliation: School of Medicine, Curtin University, Perth, Western Australia, Australia.
authors.forename: Johan
authors.initials: J
authors.lastname: Rosman
mesh_terms: D006801:Humans; D024802:Nurse's Role; D009726:Nurses / Q000592:standards*; D057184:Practice Patterns, Nurses' / Q000639:trends; D006435:Renal Dialysis / Q000451:nursing; D014463:Ultrasonography / Q000451:nursing*; D014904:Western Australia
keywords: Haemodialysis; Intradialytic hypotension; Nursing competency; Ultrasound inferior vena cava