RT Journal
A1 Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB
T1 USe of simulation-based education to reduce catheter-related bloodstream infections
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2009
FD August 10
VO 169
IS 15
SP 1420
OP 1423
DO 10.1001/archinternmed.2009.215
UL http://dx.doi.org/10.1001/archinternmed.2009.215
AB Background 
    Simulation-based education improves procedural competence in central venous catheter (CVC) insertion. The effect of simulation-based education in CVC insertion on the incidence of catheter-related bloodstream infection (CRBSI) is unknown. The aim of this study was to determine if simulation-based training in CVC insertion reduces CRBSI.Methods 
    This was an observational education cohort study set in an adult intensive care unit (ICU) in an urban teaching hospital. Ninety-two internal medicine and emergency medicine residents completed a simulation-based mastery learning program in CVC insertion skills. Rates of CRBSI from CVCs inserted by residents in the ICU before and after the simulation-based educational intervention were compared over a 32-month period.Results 
    There were fewer CRBSIs after the simulator-trained residents entered the intervention ICU (0.50 infections per 1000 catheter-days) compared with both the same unit prior to the intervention (3.20 per 1000 catheter-days) (P = .001) and with another ICU in the same hospital throughout the study period (5.03 per 1000 catheter-days) (P = .001).Conclusions 
    An educational intervention in CVC insertion significantly improved patient outcomes. Simulation-based education is a valuable adjunct in residency education.