The Application of Nurse-Led Bedside Critical Care Ultrasound in Paediatric and Neonatal Nursing Practice: A Scoping Review.

چکیده اصلی

BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly used in paediatric and neonatal critical care, but evidence on nurse-led bedside POCUS remains limited and fragmented. AIMS: This scoping review aimed to map the evidence on nurse-led bedside POCUS in paediatric and neonatal critical care nursing practice, examine implementation factors and identify evidence gaps relevant to nursing research, education and clinical practice. METHODS: Following JBI methodology and PRISMA-ScR guidance, we searched PubMed, Embase, CINAHL, Web of Science, Cochrane Library and CNKI from inception to October 2025. Eligibility followed the PCC framework. Two reviewers independently screened records and extracted data using a standardized form. Study characteristics were synthesized descriptively, and implementation factors were deductively analysed using the COM-B framework. RESULTS: Thirty-four studies were included, mainly from the United States and China. Nurse-led POCUS applications included vascular access, respiratory assessment, catheter localization, cardiac or hemodynamic evaluation, bladder assessment and education or competency development. Outcomes included clinical (procedural success and diagnostic accuracy), process (timeliness and workflow efficiency) and nurse-related (competency, confidence and role development). Safety-related outcomes were the least reported. Implementation was influenced by training, equipment, protected time, institutional support, collaboration and patient safety concerns. The automatic motivation domain, referring to unconscious drivers such as habits and emotional responses, was not addressed by any study. CONCLUSIONS: Nurse-led POCUS is an emerging but unevenly developed component of paediatric and neonatal critical care. Brief training may support initial competency, but sustained implementation is constrained by underdeveloped quality assurance, unclear career pathways and limited attention to motivational processes. RELEVANCE TO CLINICAL PRACTICE: Future nursing research and clinical programmes may look beyond short-term training outcomes to consider competency standards, longitudinal supervision, quality assurance, educational approaches combining foundational POCUS training with structured workplace supervision and sustainable integration into routine care delivery.

ترجمه فارسی چکیده

پرستار-رهبری سونوگرافی مراقبت‌های ویژه اورژانسی سرپایی (POCUS) در مراقبت‌های ویژه کودکان و نوزادان، شواهد محدود و پراکنده‌ای دارد. این مرور جامع هدف آن مپ‌سازی شواهد، بررسی عوامل پیاده‌سازی و شناسایی شکاف‌های شناختی در تحقیق، آموزش و عملیات پرستاری است. بر اساس روش‌شناسی JBI و راهنمای PRISMA-ScR، مطالعات در پایگاه‌های PubMed، Embase، CINAHL، Web of Science، Cochrane Library و CNKI از آغاز تا اکتبر ۲۰۲۵ جستجو شدند. ۳۴ مطالعه شامل شد که عمدتاً از ایالات متحده و چین بودند. کاربردها شامل دسترسی عروقی، ارزیابی تنفسی، یافتن سوند، ارزیابی قلبی یا همودینامیک، ارزیابی مثانه و آموزش یا توسعه مهارت بود. نتایج شامل موفقیت پروسیجرال، دقت تشخیصی، سرعت و کارایی جریان کار، و مهارت، اعتماد به نفس و توسعه نقش پرستار بود. پیاده‌سازی تحت تأثیر آموزش، تجهیزات، زمان محافظت شده، حمایت نهادی، همکاری و نگرانی‌های ایمنی بود. پیاده‌سازی پایدار محدودیت‌هایی نظیر کیفیت‌assurance ناکافی، مسیر شغلی مبهم و توجه کم به فرآیندهای انگیزشی دارد.

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