Nurses’ learning curves for ultrasound assessment of gastric content: a prospective cohort study

Background Gastric point-of-care ultrasonography (G-POCUS) is a novel non-invasive technique for bedside assessment of gastric content that can be performed by non-radiologic healthcare professionals, including nurses. Real-time insight into the gastric content may facilitate objective decision-making during postoperative care, such as the placement or removal of nasogastric tubes or the initiation and progression of enteral feeding. To innovate this essential aspect of nursing care, thorough implementation of G-POCUS through education is required. However, the literature remains inconclusive on the number of scans necessary for nurses to achieve competency in GPOCUS. Aim To determine the amount of training required for nurses to achieve competence in the bedside point-of-care ultrasound for gastric content assessment. Methods In a prospective educational cohort study , eight bachelor-level nurses without prior ultrasound experience enrolled in a structured training program for gastric ultrasound. They performed gastric ultrasound on healthy volunteers without abnormal upper gastrointestinal anatomy or diagnosis of diabetes. The primary outcome was to determine the number of scans a nurse requires to achieve competence in G-POCUS, defined as a 90% success rate in 10 consecutive assessments. Expert examiners served as the reference standard. Nurses were blinded to the randomized prandial status of the volunteers. Data analysis included cumulative sum scores and Bush and Mosteller’s learning model to estimate the number of examinations required to reach a 95% success rate. Results A total of 512 assessments were conducted by eight nurses. All nurses achieved competence after a median of 23 attempts. The learning model indicated that approximately 30 scans were needed to achieve a 95% success rate. Conclusions Structured training enables nurses to develop competency in GPOCUS, with at least 30 assessments required for skill competency when performed on healthy subjects. These findings support broader adoption of gastric ultrasound within nursing practice.