Impact of Nurse-Performed Point-of-Care Ultrasound (PoCUS) in Adult Intensive Care: A Systematic Review

BACKGROUND/OBJECTIVES: Point-of-care ultrasound (POCUS) is increasingly used in intensive care units (ICUs) as a rapid bedside diagnostic tool supporting timely clinical assessment. The impact of nurse-performed POCUS on clinical management, procedural performance, and professional practice in adult ICUs has not yet been systematically synthesized. This review aimed to evaluate the integration of nurse-performed POCUS into nursing care and its effects on technical, decision-making, and professional outcomes. METHODS: A systematic review was conducted in accordance with PRISMA 2020 and the JBI Manual for Evidence Synthesis. PubMed, Scopus, CINAHL, and Web of Science were searched without time restrictions. Original studies were included if they involved adult ICU patients and evaluated POCUS performed by nurses, reporting clinical, procedural, or professional outcomes. Methodological quality was assessed using JBI and MMAT checklists according to study design. RESULTS: Eleven studies were included. The results were synthesized into four primary domains: (1) support for the clinical decision-making process, (2) technical performance and procedural outcomes, (3) diagnostic accuracy, and (4) professional autonomy, training, and sustainability of competencies. Nurse-performed POCUS was associated with management changes in 26-67% of assessments and improved first-attempt success in ultrasound-guided peripheral venous access. Diagnostic accuracy was acceptable when supported by structured training, with no reported increase in complications. CONCLUSIONS: Nurse-performed POCUS in adult ICUs appears safe and practice-enhancing, supporting decision-making and selected procedural outcomes. Further multi-center controlled studies are required to clarify its impact on major clinical endpoints and long-term outcomes.