Standardization of Internal Jugular Central Venous Catheter Insertion Between Multiple Specialties with Simulation




Weia, Benjamin Chun-Bang

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BACKGROUND: Insertion of central venous catheters is a medical procedure with the risk of adverse outcomes. Between the different specialties at the University of Texas Southwestern Medical Center (UT Southwestern), there is a wide variation in the training and performance of the procedure. At other medical institutions, standardization of central venous catheter insertion decreased the frequency of adverse outcomes including failure, infection, pneumothorax, and arterial puncture. SPECIFIC AIM: Increase compliance with a standardized method for central venous catheter insertion among resident physicians in six departments at UT Southwestern to 95% as measured by a checklist by July 2019. METHODS: Consensus was achieved on a standardized method between six departments by a modified Delphi method. A training curriculum was created for the standardized method by following the Define-Measure-Analyze-Design-Validate (DMADV) framework. In designing the curriculum, strategies were utilized from implementation science, mastery-based learning, and simulation education. During the design phase, the curriculum was improved through two Plan-Do-Study-Act cycles with two pilot training sessions. RESULTS: Created a checklist for measuring compliance to the standardized method and a written exam for measuring knowledge required for the method. Designed multiple manuals and a video for learners and educators to standardize the training. CONCLUSION: A standardized method for inserting central venous catheters has been developed with consensus between multiple departments in a large academic institution. To introduce compliance with the method, a simulation-based training curriculum has been implemented. These achievements allow for the following phase of training resident physicians at UT Southwestern and measuring for an increase in compliance to the standardized method for central venous catheter insertion.

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