A Prerotational, Simulation-Based Workshop Improves the Safety of Central Venous Catheter Insertion

Sekiguchi, Hiroshi; Tokita, Joji; Minami, Taro; Eisen, Lewis; Mayo, Paul H.; Narasimhan, Mangala

doi:10.1378/chest.10-3319

Cited by 46 publications

(46 citation statements)

References 14 publications

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“…High stake scenarios, such as advanced bronchoscopy procedures or cardiac arrest scenarios, can be simulated and repeated as needed in a controlled environment with no risk to patients. With simulation-based educational programs demonstrating improved outcomes in central venous catheter insertion [3,4] , laparoscopic surgery [37] and thoracentesis [38] , it seems likely that future studies will demonstrate similar improvements in bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Learning medical procedures in patient care in a high stress environment can lead to excessive learner activation, resulting in decreased learning retention [40] . Evidence supporting the use of simulation-based curricula in procedural education continues to accumulate [5] , as does evidence against the traditional use of patients as practice subjects for trainees learning medical and surgical procedures [3,4,[36][37][38][39][40] . Our data add further support to the importance of finding new nonpatient-based methods of learning procedural skills.…”

Section: Discussionmentioning

confidence: 99%

“…Procedural training experts have proposed that patient-based teaching methods (also known as the apprenticeship model of procedural learning or the see-one, do-one and teach-one method) can result in increased erroneous diagnoses, increased patient discomfort and increased risk for procedure-related morbidity [1] . Higher complication rates have been demonstrated in inexperienced operators for central venous catheter insertion when the apprenticeship model of procedural learning is used [2] , whereas improved clinical outcomes have been demonstrated with the use of simulation-based educational programs [3][4][5] . Although there is some limited evidence addressing the impact of trainees on outcomes of other medical procedures such as lumbar puncture [6] and thoracentesis [7] , there remains a paucity of studies looking at how residency procedural training influences patient outcome [8] .…”

Section: Introductionmentioning

confidence: 99%

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Trainee Impact on Procedural Complications: An Analysis of 967 Consecutive Flexible Bronchoscopy Procedures in an Interventional Pulmonology Practice

et al. 2013

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In an academic interventional pulmonology practice utilizing the apprenticeship model for procedural education, trainee participation in procedures can increase procedure time and the amount of sedation required, and result in increased complications. Medical procedural training methods that do not involve practicing on patients warrant further investigation in order to reduce the burden of procedural learning for patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trainee Impact on Procedural Complications: An Analysis of 967 Consecutive Flexible Bronchoscopy Procedures in an Interventional Pulmonology Practice

et al. 2013

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“…[2][3][4][5][6][7] Education and training of health care providers feature prominently in the CLABSI prevention guidelines published by the Centers for Disease Control and Prevention (CDC). 5 Simulation-based training for the placement of central venous catheters (CVCs) is superior to the apprenticeship model ("see one, do one, teach one"), [8][9][10] is associated with reduction in CLABSI rates, 8,11 and is likely to reduce intensive care unit (ICU) costs. 12 Several studies showed high CLABSI rates in CVCs placed in the emergency department (ED), which may be due to time pressures, workload, and reliability of supervision.…”

mentioning

confidence: 99%

Simulation‐based Training for Emergency Medicine Residents in Sterile Technique During Central Venous Catheterization: Impact on Performance, Policy, and Outcomes

Hoskote

Khouli

Lanoix

et al. 2014

Academic Emergency Medicine

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Objectives: Central line-associated bloodstream infection (CLABSI) is a preventable nosocomial infection. Simulation-based training in sterile technique during central venous catheter (CVC) placement for emergency medicine (EM) residents, and its effect on changing the medical intensive care unit (MICU) practice of routine replacement of CVCs placed under sterile technique in the emergency department (ED), has not been evaluated. Methods:Emergency medicine residents received simulation-based sterile technique training during CVC placement between May 2008 and September 2010. Between June 2008 and January 2011, the authors reviewed records of patients who had CVCs placed in the ED under sterile technique by EM residents and were admitted to the MICU (group 1) and CVCs placed in the MICU under sterile technique by internal medicine (IM) residents (group 2). IM residents completed similar simulation-based training before May 2008. Changes in EM residents' sterile technique performance scores were compared, as well as CLABSI rates in both groups. EM residents' CVC procedural skills were not assessed.Results: Seventy-six EM residents completed simulation-based training with significant improvement in performance (median scores 13 out of 24 before training, 24 out of 24 after training; p < 0.001). CLABSI rates per 1,000 catheter-days were 1.02 in group 1 and 1.02 in group 2 (p = 0.99). Both groups had similar demographics, acuity, and mortality (p > 0.5).Conclusions: Routine replacement of CVCs placed in the ED under sterile technique after simulationbased training would appear to be unnecessary. These findings demonstrate patient-centered outcomes that are comparable for CVCs in ED-admitted MICU patients, regardless of whether the CVC was placed in the ED or MICU.ACADEMIC EMERGENCY MEDICINE 2015;22:81-87

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“…In recent years, the effectiveness of HPS education in infection control practices has been investigated on medical education [9][10][11] . However, there is currently a lack of knowledge about the effectiveness of HPS education in improving infection control practices on nursing continuing education.…”

mentioning

confidence: 99%

Effectiveness of human patient simulation education in improving infection control practices – A systematic review

Jansson

Kyngäs

Kääriäinen

2013

JNEP

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Background: Continuing education of healthcare personnel has been shown to play an essential role in infection control, associated with a sustained improvement in learning and clinical outcomes. However, the effectiveness of previous educational interventions in infection control is rather limited. Therefore, the aim of the study was to evaluate the effectiveness of human patient simulation (HPS) education in improving infection control practices on nursing continuing education. Methods:A search strategy was conducted in eight multi-disciplinary databases and formulated in association with an information specialist (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012). Two content and methodological experts selected the studies and assessed their quality independently. Only intervention studies, used alone or in conjunction with other educational interventions, were included in the review.Results: Due to a lack of available studies, only one study was included in the final review. According to the results of that study, the use of patient biosimulator with a visual demonstration may have significant advantages in changing the behavior of healthcare personnel regarding infection control practices. Conclusion:The effectiveness of HPS education in improving infection control practices on nursing continuing education is still uncertain due to the lack of published studies and robust evidence. There is a need for new, innovative educational intervention studies to educate, evaluate and improve knowledge, attitudes and performance regarding hand hygiene practices and invasive procedures.

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A Prerotational, Simulation-Based Workshop Improves the Safety of Central Venous Catheter Insertion

Cited by 46 publications

References 14 publications

Trainee Impact on Procedural Complications: An Analysis of 967 Consecutive Flexible Bronchoscopy Procedures in an Interventional Pulmonology Practice

Trainee Impact on Procedural Complications: An Analysis of 967 Consecutive Flexible Bronchoscopy Procedures in an Interventional Pulmonology Practice

Simulation‐based Training for Emergency Medicine Residents in Sterile Technique During Central Venous Catheterization: Impact on Performance, Policy, and Outcomes

Effectiveness of human patient simulation education in improving infection control practices – A systematic review

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