Background: Lumbar punctures (LPs) are common among hospitalized patients and many institutions have implemented a hospital medicine procedure services (HMPS) to perform these routine bedside procedures. Most clinicians learn to perform this procedure using the midline (ML), landmark-guided approach which involves palpation of the lumbar spine but this technique is associated with failure rates as [...]

Background: Diagnosis of complications is important for patient care, diagnostic quality, and safety. Paracentesis is a common procedure among hospitalized patients. The use of ultrasound decreases complications and improves safety. We aimed to characterize the complication rate observed among paracenteses performed by a hospital medicine bedside procedures service (MPS) before and after a transition to [...]

Background: The scope of Point-of-Care Ultrasound (POCUS) use in hospital medicine continues to expand. Despite the noted benefits in diagnostic accuracy, the use of POCUS in hospital medicine is varied. A prospective study of hospitalists in 2022 showed that diagnostic POCUS use has increased nationally for cardiac, pulmonary, and abdominal applications. The most common barrier [...]

Background: Ultrasound guided peripheral IV (USGPIV) placement is a critical skill that currently requires placement by providers or critical care nurses at Yale-New Haven Hospital. In particular, our Liver and Kidney Transplant unit requires frequent support for IV access placement from our Hospitalist Procedure Team (HPT) and critical care nursing intervention (SWAT team). There are [...]

Background: POCUS is rapidly becoming an important tool in Hospital Medicine (HM) and is endorsed by the Society of Hospital Medicine (SHM).​Many medical schools and physician residency programs have recognized the clinical value of POCUS and subsequently come to incorporate competency as a core clinical skill for graduation.APP programs, however, have lagged behind with only [...]