Nurses’ Challenges in Performing Ultrasound Hip‐Screening Techniques for Home Visits to Newborns and Infants: A Descriptive Case Study

AIMS: Early detection of developmental dysplasia of the hip in newborns and infants is essential to ensure lifelong mobility. As several municipalities conduct nurse-led hip ultrasound screenings during newborn and infant home visits, nurses must acquire the accurate technique smoothly and effectively. Clarifying the challenges nurses face when performing ultrasound procedures helps support effective education. This study aimed to identify challenges inexperienced nurses face when performing basic ultrasound using the Graf-method in home settings. DESIGN: Descriptive case study. METHODS: Ultrasound training was provided to 22 nurses in Japan to enable use during newborn and infant home visits. We analyzed 25 video cases from three nurses who required > 180 s to obtain a standard plane image. Videos were transcribed and inductively analyzed to identify challenges with reference to Yin's case study methodology. RESULTS: Conditions of the challenges were categorized into knowledge, skills, and attitudes with reference to Bloom's taxonomy. The knowledge gap led to the failure to correctly judge whether the femoral head/standard plane was captured. Skill deficiencies led to failure to move the probe vertically and difficulty maintaining the infant's straight lateral position. The combination of inadequate knowledge and skills resulted in failures to (1) place the probe directly over the femoral head, (2) display the image in the correct position and orientation, and (3) move the probe correctly regarding direction and range while maintaining the image in the correct position and orientation. Regarding attitude gaps, nurses failed to improve the procedure. CONCLUSIONS: Improving ultrasound proficiency for developmental hip dysplasia detection requires training in anatomy integration, sensory experience, and probe-screen coordination while addressing posture, equipment handling, and motor skills. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trial Registry: UMIN000051929.