Ultrasound research to practice in the prenatal detection of congenital heart defects

The American Institute of Ultrasound in Medicine (2013b) recommended the addition of an interrogation process called OFTV to improve prenatal detection rates of critical CHD that represented a significant departure in ultrasound imaging practice. The purpose of this research study was to assess mediating factors or barriers that influenced sonographer’s practice of OFTV inclusion during routine obstetrical ultrasounds between 18-22 weeks gestation. Factors included attitude and perceived behavioral control (PBC) toward OFTV inclusion and credentialing status. The relationships between OFTV inclusion, credentialing status, educational attainment, and facility accreditation were also examined. Attitude and perceived behavioral control constructs from the theory of planned behavior served as a theoretical framework. A mixed method approach collected primary quantitative and qualitative datum. The dependent variable was OFTV inclusion. A convenience sample of 109 ARDMS credentialed sonographers in the United States responded to a one shot survey, the majority of who performed obstetrical ultrasounds for more than ten years. Findings revealed that attitude and PBC correlated with OFTV inclusion, with attitude and OFTV inclusion having the highest significant correlation (r= .592), at p= .01. No significant correlation was found between PBC and overall scanning practice behaviors (r= .058). At p = .01, there was a significant correlation between OFTV inclusion and ARDMS obstetrical credentialing (r=. 279). However, there were no significant correlations between OFTV inclusion and education (r- .0060) or OFTV inclusion and facility accreditation (r- .009). At p= .01, results also revealed significant correlations between OB credentialing status and overall scanning practices (r= .279). Analyses for the null hypotheses confirmed ARDMS obstetrical credentialing status had the greatest impact on OFTV inclusion. Qualitative analyses revealed maternal obesity and poor fetal lie as the most common barriers to OFTV inclusion. However, the majority of barriers reported were environmental in nature to include time restrictions and scanning protocols. This study provided a baseline translation (adoption rate) of 62% with a rejection rate of 18%. A larger sample of obstetrical sonographers in the United States may provide a fuller understanding of the mediating factors or barriers that influence ultrasound research of OFTV inclusion to bedside practice.