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Simulation-Based Education Enhances Patient Safety Behaviors During Central Venous Catheter Placement

Jagneaux Tonya MD; Caffery, Terrell S. MD; Musso, Mandi Wilkes PhD; Long, Ann C. MD, MS; Zatarain, Lauren MD; Stopa, Erik DO; Freeman, Nathan MD; Quin, Cara Cantelli MD; Jones, Glenn N. PhD
doi: 10.1097/PTS.0000000000000425
Original Article: PDF Only

Objective

We describe the effect of simulation-based education on residents' adherence to protocols for and performance of central venous access.

Methods

Internal medicine and emergency medicine residents underwent a central venous access course that included a lecture, video presentation, readings, and simulation demonstrations presented by faculty. Baseline data were collected before the course was initiated. After a skills session where they rehearsed their ultrasound-guided central venous access skills, residents were evaluated using a procedural checklist and written knowledge exam. Residents also completed questionnaires regarding confidence in performing ultrasound-guided central venous access and opinions about the training course.

Results

Residents demonstrated significant improvement on the written knowledge exam (P < 0.0001) and Standard Protocol Checklist (P < 0.0001) after the training course. Training improved a number of patient safety elements, including adherence to sterile technique, transparent dressing, discarding sharps, and ordering postprocedure x-rays. However, a number of residents failed to wash their hands, prepare with chlorhexidine, drape the patient using a sterile technique, anesthetize the site, and perform a preprocedure time-out. Significant improvement in procedural skills was also noted for reduction in skin-to-vein time (P < 0.003) as well as a reduction in number of residents who punctured the carotid artery (P < 0.02).

Conclusions

Simulation-based education significantly improved residents' knowledge and procedural skills along with their confidence. Adherence to the protocol also improved. This study illustrates that simulation-based education can improve patient safety through training and protocols.

Correspondence: Mandi Musso, PhD, 5246 Brittany Dr, Baton Rouge, LA 70808 (e-mail: mmuss1@lsuhsc.edu).

The authors disclose no conflict of interest.

T.C. and T.J. received the Louisiana State University Health Sciences Center Educational Enhancement Grant 2010–2011 to fund this project.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.journalpatientsafety.com).

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