Attending Physician Adherence to a 29-Component Central Venous Catheter Bundle Checklist During Simulated Procedures
OBJECTIVES:Central venous catheter insertions may lead to preventable adverse events. Attending physicians’ central venous catheter insertion skills are not assessed routinely. We aimed to compare attending physicians’ simulated central venous catheterinsertion performance to published competency st...
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| Veröffentlicht in: | Critical care medicine 2016-10, Vol.44 (10), p.1871-1881 |
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| creator | Barsuk, Jeffrey H. Cohen, Elaine R. Nguyen, Duyhuu Mitra, Debi O’Hara, Kelly Okuda, Yasuharu Feinglass, Joe Cameron, Kenzie A. McGaghie, William C. Wayne, Diane B. |
| description | OBJECTIVES:Central venous catheter insertions may lead to preventable adverse events. Attending physicians’ central venous catheter insertion skills are not assessed routinely. We aimed to compare attending physicians’ simulated central venous catheterinsertion performance to published competency standards.
DESIGN:Prospective cohort study of attending physicians’ simulated internal jugular and subclavian central venous catheter insertion skills versus a historical comparison group of residents who participated in simulation training.
SETTING:Fifty-eight Veterans Affairs Medical Centers from February 2014 to December 2014 during a 2-day simulation-based education curriculum and two academic medical centers in Chicago.
SUBJECTS:A total of 108 experienced attending physicians and 143 internal medicine and emergency medicine residents.
INTERVENTION:None.
MEASUREMENTS AND MAIN RESULTS:Using a previously published central venous catheter insertion skills checklist, we compared Veterans Affairs Medical Centers attending physicians’ simulated central venous catheter insertion performance to the same simulated performance by internal medicine and emergency medicine residents from two academic centers. Attending physician performance was compared to residents’ baseline and posttest (after simulation training) performance. Minimum passing scores were set previously by an expert panel. Attending physicians performed higher on the internal jugular (median, 75.86% items correct; interquartile range, 68.97–86.21) and subclavian (median, 83.00%; interquartile range, 59.00–86.21) assessments compared to residents’ internal jugular (median, 37.04% items correct; interquartile range, 22.22–68.97) and subclavian (median, 33.33%; interquartile range, 0.00–70.37; both p < 0.001) baseline assessments. Overall simulated performance was poor because only 12 of 67 attending physicians (17.9%) met or exceeded the minimum passing score for internal jugular central venous catheter insertion and only 11 of 47 (23.4%) met or exceeded the minimum passing score for subclavian central venous catheter insertion. Resident posttest performance after simulation training was significantly higher than attending physician performance (internal jugularmedian, 96%; interquartile range, 93.10–100.00; subclavianmedian, 100%; interquartile range, 96.00–100.00; both p < 0.001).
CONCLUSIONS:This study demonstrates highly variable simulated central venous catheter insertion performance among a national c |
| doi_str_mv | 10.1097/CCM.0000000000001831 |
| format | Article |
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DESIGN:Prospective cohort study of attending physicians’ simulated internal jugular and subclavian central venous catheter insertion skills versus a historical comparison group of residents who participated in simulation training.
SETTING:Fifty-eight Veterans Affairs Medical Centers from February 2014 to December 2014 during a 2-day simulation-based education curriculum and two academic medical centers in Chicago.
SUBJECTS:A total of 108 experienced attending physicians and 143 internal medicine and emergency medicine residents.
INTERVENTION:None.
MEASUREMENTS AND MAIN RESULTS:Using a previously published central venous catheter insertion skills checklist, we compared Veterans Affairs Medical Centers attending physicians’ simulated central venous catheter insertion performance to the same simulated performance by internal medicine and emergency medicine residents from two academic centers. Attending physician performance was compared to residents’ baseline and posttest (after simulation training) performance. Minimum passing scores were set previously by an expert panel. Attending physicians performed higher on the internal jugular (median, 75.86% items correct; interquartile range, 68.97–86.21) and subclavian (median, 83.00%; interquartile range, 59.00–86.21) assessments compared to residents’ internal jugular (median, 37.04% items correct; interquartile range, 22.22–68.97) and subclavian (median, 33.33%; interquartile range, 0.00–70.37; both p < 0.001) baseline assessments. Overall simulated performance was poor because only 12 of 67 attending physicians (17.9%) met or exceeded the minimum passing score for internal jugular central venous catheter insertion and only 11 of 47 (23.4%) met or exceeded the minimum passing score for subclavian central venous catheter insertion. Resident posttest performance after simulation training was significantly higher than attending physician performance (internal jugularmedian, 96%; interquartile range, 93.10–100.00; subclavianmedian, 100%; interquartile range, 96.00–100.00; both p < 0.001).
CONCLUSIONS:This study demonstrates highly variable simulated central venous catheter insertion performance among a national cohort of experienced attending physicians. Hospitals, healthcare systems, and governing bodies should recognize that even experienced physicians require periodic clinical skill assessment and retraining.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0000000000001831</identifier><identifier>PMID: 27336437</identifier><language>eng</language><publisher>United States: by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc</publisher><subject>Academic Medical Centers ; Adult ; Catheterization, Central Venous - methods ; Catheterization, Central Venous - standards ; Checklist ; Chicago ; Clinical Competence ; Female ; Humans ; Male ; Manikins ; Middle Aged ; Models, Biological ; Physicians - standards ; Prospective Studies ; United States ; United States Department of Veterans Affairs</subject><ispartof>Critical care medicine, 2016-10, Vol.44 (10), p.1871-1881</ispartof><rights>by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.</rights><rights>Copyright © by 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4011-f4e065e704f1938b47a881916f1744a3dc025a3412d0e1157afc5fb1dcb63a1b3</citedby><cites>FETCH-LOGICAL-c4011-f4e065e704f1938b47a881916f1744a3dc025a3412d0e1157afc5fb1dcb63a1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27336437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barsuk, Jeffrey H.</creatorcontrib><creatorcontrib>Cohen, Elaine R.</creatorcontrib><creatorcontrib>Nguyen, Duyhuu</creatorcontrib><creatorcontrib>Mitra, Debi</creatorcontrib><creatorcontrib>O’Hara, Kelly</creatorcontrib><creatorcontrib>Okuda, Yasuharu</creatorcontrib><creatorcontrib>Feinglass, Joe</creatorcontrib><creatorcontrib>Cameron, Kenzie A.</creatorcontrib><creatorcontrib>McGaghie, William C.</creatorcontrib><creatorcontrib>Wayne, Diane B.</creatorcontrib><title>Attending Physician Adherence to a 29-Component Central Venous Catheter Bundle Checklist During Simulated Procedures</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVES:Central venous catheter insertions may lead to preventable adverse events. Attending physicians’ central venous catheter insertion skills are not assessed routinely. We aimed to compare attending physicians’ simulated central venous catheterinsertion performance to published competency standards.
DESIGN:Prospective cohort study of attending physicians’ simulated internal jugular and subclavian central venous catheter insertion skills versus a historical comparison group of residents who participated in simulation training.
SETTING:Fifty-eight Veterans Affairs Medical Centers from February 2014 to December 2014 during a 2-day simulation-based education curriculum and two academic medical centers in Chicago.
SUBJECTS:A total of 108 experienced attending physicians and 143 internal medicine and emergency medicine residents.
INTERVENTION:None.
MEASUREMENTS AND MAIN RESULTS:Using a previously published central venous catheter insertion skills checklist, we compared Veterans Affairs Medical Centers attending physicians’ simulated central venous catheter insertion performance to the same simulated performance by internal medicine and emergency medicine residents from two academic centers. Attending physician performance was compared to residents’ baseline and posttest (after simulation training) performance. Minimum passing scores were set previously by an expert panel. Attending physicians performed higher on the internal jugular (median, 75.86% items correct; interquartile range, 68.97–86.21) and subclavian (median, 83.00%; interquartile range, 59.00–86.21) assessments compared to residents’ internal jugular (median, 37.04% items correct; interquartile range, 22.22–68.97) and subclavian (median, 33.33%; interquartile range, 0.00–70.37; both p < 0.001) baseline assessments. Overall simulated performance was poor because only 12 of 67 attending physicians (17.9%) met or exceeded the minimum passing score for internal jugular central venous catheter insertion and only 11 of 47 (23.4%) met or exceeded the minimum passing score for subclavian central venous catheter insertion. Resident posttest performance after simulation training was significantly higher than attending physician performance (internal jugularmedian, 96%; interquartile range, 93.10–100.00; subclavianmedian, 100%; interquartile range, 96.00–100.00; both p < 0.001).
CONCLUSIONS:This study demonstrates highly variable simulated central venous catheter insertion performance among a national cohort of experienced attending physicians. Hospitals, healthcare systems, and governing bodies should recognize that even experienced physicians require periodic clinical skill assessment and retraining.</description><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>Catheterization, Central Venous - methods</subject><subject>Catheterization, Central Venous - standards</subject><subject>Checklist</subject><subject>Chicago</subject><subject>Clinical Competence</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Manikins</subject><subject>Middle Aged</subject><subject>Models, Biological</subject><subject>Physicians - standards</subject><subject>Prospective Studies</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtv1TAQRi1ERS-Ff4CQl2xSPBnn4eUlPKVWrcRjGzn2hIQ6zsV2VPXfk-gWhFhQL8aydL5vrMPYCxDnIFT1umkuz8VfB2qER2wHBYpM5Aofs50QSmQoFZ6ypzH-WBlZVPiEneYVYimx2rG0T4m8Hf13fj3cxdGM2vO9HSiQN8TTzDXPVdbM02H25BNv1hG049_Iz0vkjU4DJQr8zeKtI94MZG7cGBN_u4St9fM4LU4nsvw6zIbsEig-Yye9dpGe399n7Ov7d1-aj9nF1YdPzf4iM1IAZL0kURZUCdmDwrqTla5rUFD2UEmp0RqRFxol5FYQQFHp3hR9B9Z0JWro8Iy9OvYewvxzoZjaaYyGnNOe1s-3UOeiUFJKXFF5RE2YYwzUt4cwTjrctSDazXe7-m7_9b3GXt5vWLqJ7J_Qb8ErUB-B29mtmuKNW24ptANpl4aHuuV_ohuGuSyzXEAJ2yvbhsJft4mbjA</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Barsuk, Jeffrey H.</creator><creator>Cohen, Elaine R.</creator><creator>Nguyen, Duyhuu</creator><creator>Mitra, Debi</creator><creator>O’Hara, Kelly</creator><creator>Okuda, Yasuharu</creator><creator>Feinglass, Joe</creator><creator>Cameron, Kenzie A.</creator><creator>McGaghie, William C.</creator><creator>Wayne, Diane B.</creator><general>by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc</general><general>Copyright by by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161001</creationdate><title>Attending Physician Adherence to a 29-Component Central Venous Catheter Bundle Checklist During Simulated Procedures</title><author>Barsuk, Jeffrey H. ; Cohen, Elaine R. ; Nguyen, Duyhuu ; Mitra, Debi ; O’Hara, Kelly ; Okuda, Yasuharu ; Feinglass, Joe ; Cameron, Kenzie A. ; McGaghie, William C. ; Wayne, Diane B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4011-f4e065e704f1938b47a881916f1744a3dc025a3412d0e1157afc5fb1dcb63a1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Academic Medical Centers</topic><topic>Adult</topic><topic>Catheterization, Central Venous - methods</topic><topic>Catheterization, Central Venous - standards</topic><topic>Checklist</topic><topic>Chicago</topic><topic>Clinical Competence</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Manikins</topic><topic>Middle Aged</topic><topic>Models, Biological</topic><topic>Physicians - standards</topic><topic>Prospective Studies</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barsuk, Jeffrey H.</creatorcontrib><creatorcontrib>Cohen, Elaine R.</creatorcontrib><creatorcontrib>Nguyen, Duyhuu</creatorcontrib><creatorcontrib>Mitra, Debi</creatorcontrib><creatorcontrib>O’Hara, Kelly</creatorcontrib><creatorcontrib>Okuda, Yasuharu</creatorcontrib><creatorcontrib>Feinglass, Joe</creatorcontrib><creatorcontrib>Cameron, Kenzie A.</creatorcontrib><creatorcontrib>McGaghie, William C.</creatorcontrib><creatorcontrib>Wayne, Diane B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barsuk, Jeffrey H.</au><au>Cohen, Elaine R.</au><au>Nguyen, Duyhuu</au><au>Mitra, Debi</au><au>O’Hara, Kelly</au><au>Okuda, Yasuharu</au><au>Feinglass, Joe</au><au>Cameron, Kenzie A.</au><au>McGaghie, William C.</au><au>Wayne, Diane B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Attending Physician Adherence to a 29-Component Central Venous Catheter Bundle Checklist During Simulated Procedures</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>44</volume><issue>10</issue><spage>1871</spage><epage>1881</epage><pages>1871-1881</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><abstract>OBJECTIVES:Central venous catheter insertions may lead to preventable adverse events. Attending physicians’ central venous catheter insertion skills are not assessed routinely. We aimed to compare attending physicians’ simulated central venous catheterinsertion performance to published competency standards.
DESIGN:Prospective cohort study of attending physicians’ simulated internal jugular and subclavian central venous catheter insertion skills versus a historical comparison group of residents who participated in simulation training.
SETTING:Fifty-eight Veterans Affairs Medical Centers from February 2014 to December 2014 during a 2-day simulation-based education curriculum and two academic medical centers in Chicago.
SUBJECTS:A total of 108 experienced attending physicians and 143 internal medicine and emergency medicine residents.
INTERVENTION:None.
MEASUREMENTS AND MAIN RESULTS:Using a previously published central venous catheter insertion skills checklist, we compared Veterans Affairs Medical Centers attending physicians’ simulated central venous catheter insertion performance to the same simulated performance by internal medicine and emergency medicine residents from two academic centers. Attending physician performance was compared to residents’ baseline and posttest (after simulation training) performance. Minimum passing scores were set previously by an expert panel. Attending physicians performed higher on the internal jugular (median, 75.86% items correct; interquartile range, 68.97–86.21) and subclavian (median, 83.00%; interquartile range, 59.00–86.21) assessments compared to residents’ internal jugular (median, 37.04% items correct; interquartile range, 22.22–68.97) and subclavian (median, 33.33%; interquartile range, 0.00–70.37; both p < 0.001) baseline assessments. Overall simulated performance was poor because only 12 of 67 attending physicians (17.9%) met or exceeded the minimum passing score for internal jugular central venous catheter insertion and only 11 of 47 (23.4%) met or exceeded the minimum passing score for subclavian central venous catheter insertion. Resident posttest performance after simulation training was significantly higher than attending physician performance (internal jugularmedian, 96%; interquartile range, 93.10–100.00; subclavianmedian, 100%; interquartile range, 96.00–100.00; both p < 0.001).
CONCLUSIONS:This study demonstrates highly variable simulated central venous catheter insertion performance among a national cohort of experienced attending physicians. Hospitals, healthcare systems, and governing bodies should recognize that even experienced physicians require periodic clinical skill assessment and retraining.</abstract><cop>United States</cop><pub>by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc</pub><pmid>27336437</pmid><doi>10.1097/CCM.0000000000001831</doi><tpages>11</tpages></addata></record> |
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| subjects | Academic Medical Centers Adult Catheterization, Central Venous - methods Catheterization, Central Venous - standards Checklist Chicago Clinical Competence Female Humans Male Manikins Middle Aged Models, Biological Physicians - standards Prospective Studies United States United States Department of Veterans Affairs |
| title | Attending Physician Adherence to a 29-Component Central Venous Catheter Bundle Checklist During Simulated Procedures |
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