Simulation-Based Objective Assessment Discerns Clinical Proficiency in Central Line Placement

CHEST Journal ◽  
2010 ◽  
Vol 137 (5) ◽  
pp. 1050-1056 ◽  
Author(s):  
Yue Dong ◽  
Harpreet S. Suri ◽  
David A. Cook ◽  
Kianoush B. Kashani ◽  
John J. Mullon ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Central Line ◽  
Line Placement ◽  
Simulation Based

Standardized, Interdepartmental, Simulation-Based Central Line Insertion Course Closes an Educational Gap and Improves Intern Comfort with the Procedure

2017 ◽  
Vol 83 (6) ◽  
pp. 536-540 ◽  
Author(s):  
Joanna Grudziak ◽  
Blair Herndon ◽  
Ria D. Dancel ◽  
Harendra Arora ◽  
Christopher J. Tignanelli ◽  
...  
Keyword(s):  
The United States ◽  
Central Line ◽  
Common Procedure ◽  
Central Lines ◽  
Central Line Insertion ◽  
Line Placement ◽  
Line Insertion ◽  
Primary Operator ◽  
Simulation Based ◽  
Junior Residents

Central line placement is a common procedure, routinely performed by junior residents in medical and surgical departments. Before this project, no standardized instructional course on the insertion of central lines existed at our institution, and few interns had received formal ultrasound training. Interns from five departments participated in a simulation-based central line insertion course. Intern familiarity with the procedure and with ultrasound, as well as their prior experience with line placement and their level of comfort, was assessed. Of the 99 interns in participating departments, 45 per cent had been trained as ofOctober 2015. Forty-one per cent were female. The majority (59.5%) had no prior formal ultrasound training, and 46.0 per cent had never placed a line as primary operator. Scores increased significantly, from a precourse score mean of 13.7 to a postcourse score mean of 16.1, P < 0.001. All three of the self-reported measures of comfort with ultrasound also improved significantly. All interns reported the course was “very much” helpful, and 100 per cent reported they felt “somewhat” or “much” more comfortable with the procedure after attendance. To our knowledge, this is the first hospital-wide, standardized, simulation-based central line insertion course in the United States. Preliminary results indicate overwhelming satisfaction with the course, better ultrasound preparedness, and improved comfort with central line insertion.

scholarly journals Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

2017 ◽  
Vol 4 ◽  
pp. 238212051668482 ◽  
Author(s):  
Serkan Toy ◽  
Robert SF McKay ◽  
James L Walker ◽  
Scott Johnson ◽  
Jacob L Arnett
Keyword(s):  
Medical Students ◽  
Lumbar Puncture ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Central Line ◽  
Arterial Line ◽  
Procedural Skills ◽  
Learner Centered ◽  
Line Placement ◽  
Simulation Based

Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001). Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t(23) = −2.92, P < .001, and arterial line placement, t(23) = −2.75, P < .001. Procedural performance scores for intubation ( t(23) = −17.29, P < .001), arterial line placement ( t(23) = −19.75, P < .001), lumbar puncture ( t(23) = −16.27, P < .001), and central line placement ( t(23) = −17.25, P < .001) showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

Value Analysis of Central Line Simulation-Based Education

2021 ◽  
pp. 000313482110111
Author(s):  
Nicholas J. Iglesias ◽  
Taylor P. Williams ◽  
Clifford L. Snyder ◽  
Christian Sommerhalder ◽  
Alexander Perez
Keyword(s):  
Financial Burden ◽  
Bloodstream Infections ◽  
Central Line ◽  
Complication Rates ◽  
Qualitative Synthesis ◽  
Reporting Standard ◽  
Value Analysis ◽  
Learner Analysis ◽  
Simulation Based ◽  
Value Propositions

Background Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE. Methods A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning “Cost and CLABSI,” “Cost and Central line Associated Bloodstream Infections,” and “Cost and Central Line” in their abstract and article body. Articles chosen for qualitative synthesis mentioned “simulation” in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis. Results Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs. Conclusion Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.

scholarly journals Objective Assessment Metrics for Central Line Simulators: An Exploration of Causal Factors

2020 ◽  
Vol 64 (1) ◽  
pp. 2008-2012
Author(s):  
Jessica M. Gonzalez-Vargas ◽  
Dailen C. Brown ◽  
Jason Z. Moore ◽  
David C. Han ◽  
Elizabeth H. Sinz ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Objective Assessment ◽  
Central Line ◽  
Expert Interviews ◽  
Central Venous ◽  
Patient Case ◽  
Causal Factors ◽  
Venous Catheterization ◽  
Assessment Metrics ◽  
Automated Feedback

The Dynamic Haptic Robotic Trainer (DHRT) was developed to minimize the up to 39% of adverse effects experienced by patients during Central Venous Catheterization (CVC) by standardizing CVC training, and provide automated assessments of performance. Specifically, this system was developed to replace manikin trainers that only simulate one patient anatomy and require a trained preceptor to evaluate the trainees’ performance. While the DHRT system provides automated feedback, the utility of this system with real-world scenarios and expertise has yet to be thoroughly investigated. Thus, the current study was developed to determine the validity of the current objective assessment metrics incorporated in the DHRT system through expert interviews. The main findings from this study are that experts do agree on perceptions of patient case difficulty, and that characterizations of patient case difficulty is based on anatomical characteristics, multiple needle insertions, and prior catheterization.

The Accuracy of Electrocardiogram-Controlled Central Line Placement

2007 ◽  
Vol 104 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Ralf E. Gebhard ◽  
Peter Szmuk ◽  
Evan G. Pivalizza ◽  
Vladimir Melnikov ◽  
Christianne Vogt ◽  
...  
Keyword(s):  
Central Line ◽  
Line Placement

Reducing Oncology Unit Central Line–Associated Bloodstream Infections: Initial Results of a Simulation-Based Educational Intervention

2016 ◽  
Vol 12 (1) ◽  
pp. e83-e87 ◽  
Author(s):  
Jenna Page ◽  
Maureen Tremblay ◽  
Cate Nicholas ◽  
Ted A. James
Keyword(s):  
Educational Intervention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Care Model ◽  
Simulation Based ◽  
Oncology Unit ◽  
Initial Results

A targeted educational intervention using a simulated central line care model improved competence in central line care and resulted in decreased CLABSI rates for oncology inpatients.

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists

2021 ◽  
Keyword(s):  
Lung Ultrasound ◽  
Central Line ◽  
Arterial Line ◽  
Ultrasound Guided ◽  
Pediatric Airway ◽  
Skill Sets ◽  
Additional Information ◽  
Line Placement ◽  
Extensive Training ◽  
Radiologic Imaging

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists is intended as a ready resource for both experts and novices. It will be useful to those with extensive training and experience as well as beginners and those with distant experience or training. A wealth of knowledge in the human factors of procedure design and use has been applied throughout to ensure that desired information can be easily located, that steps are clearly identified and comprehensible, and that additional information of high relevance to procedure completion is co-located and salient. This book begins with the basics but quickly progresses to advanced skill sets. It is divided into four parts. Part I starts with a primer on ultrasound machine functionality as well as procedural chapters on lung ultrasound to detect a mainstem intubation or pneumothorax and gastric ultrasound to assess gastric contents in incompletely fasted patients. Part II covers ultrasound guided peripheral intravenous line placement through the incremental advancement method, ultrasound guided arterial line placement, and ultrasound guided central line placement. Part III details several ultrasound guided regional anesthesia techniques. Part IV covers radiology of the pediatric airway and mediastinum, lungs, gastrointestinal, genitourinary, musculoskeletal, and neurologic systems.

Investigation of the nature of the process of delivering a batch of containers from the rear terminal to the port

2021 ◽  
Vol 18 (3) ◽  
pp. 385-392
Author(s):  
Gennadiy M. GROSHEV ◽  
◽  
Alexey G. KOTENKO ◽  
Nadezhda V. KLIMOVA ◽  
Natalia B. FEDOROVA ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Practical Importance ◽  
Process Models ◽  
Delivery Time ◽  
Factors Affecting ◽  
Transport Services ◽  
Factors Influencing ◽  
Simulation Based ◽  
Random Nature ◽  
Technological Model

Objective: Assessment of the need to study the process of delivering a batch of containers from the rear terminal to the port to ensure uninterrupted communication between the rear terminal and the seaport and delivery a batch of containers exactly on time. As a primary task, the problem of analyzing the factors affecting the nature of the delivery process is solved. Methods: The methods of the theory of probability and mathematical statistics were applied in terms of determining the factors that affect the nature of the delivery process. The method of constructing process models was used to create a technological model for the delivery of containers by a block train to the port. Results: A technological model of container delivery by block train is presented. Diagrams were built showing the share of the main deviations from the schedule of container trains by types of operations for traffic, traction, corporate transport services. The main factors influencing the duration of individual operations with container block trains en route and the increase in the delivery time for a batch of containers from rear terminals to the seaport as a whole are identified. The random nature of the duration of the delivery of containers by block trains following the schedule has been established. Practical importance: The need to improve the methodology for choosing a method for delivering containers from the rear terminal to the port using simulation based on the identified factors influencing individual elements of the technological model of container delivery by a block train, deviations from the delivery time of containers, scheduled running of block trains is shown.

Central Line Placement

ICU Protocols ◽  
2020 ◽  
pp. 383-395
Author(s):  
Rajesh Chawla ◽  
Vishakh Varma ◽  
Sudha Kansal ◽  
Roseleen Kaur Bali
Keyword(s):  
Central Line ◽  
Line Placement
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