Study is performed to evaluate the effectiveness of a simulation-based workshop with ultrasonography instruction in reducing mechanical complications associated with central venous catheter(CVC) insertion.
56 medical house staff were trained prior to their rotations over a 6-month period. The data on mechanical complication rates after the implementation of the workshop were compared with previous experience when no structured educational program existed.
Results: There were 334 procedures in the preeducation period compared to 402 procedures in the posteducation period.
- The overall complication rate in the preeducation and posteducation period was 32.9% and 22.9%, respectively
- Placement failure rate decreased from 22.8% to 16.2%
- arterial punctures decreased from 4.2% to 1.5% Ultrasonography usage increased from 3.0% to 61.4%
- Multivariate analysis demonstrated that interns were more likely to cause overall mechanical complications compared with fellows and attending physicians in the preeducation period (P = .02); however, this trend was not observed in the posteducation period.
- Catheter site and ultrasonography usage significantly affected the overall complication rate in both periods, and ultrasound-guided femoral CVC was the safest procedure in the posteducation period.
It was concluded by authors that Implementation of a prerotational workshop significantly improved the safety of CVC insertion, especially for CVCs placed by inexperienced operators.
A Prerotational, Simulation-Based Workshop Improves the Safety of Central Venous Catheter Insertion Results of a Successful Internal Medicine House Staff Training Program - CHEST September 2011 vol. 140 no. 3 652-658