Teaching Aseptic Technique for Central Venous Access Under Ultrasound Guidance: A Randomized Trial Comparing Didactic Training Alone to Didactic Plus Simulation-Based Training

摘要

Adverse outcomes associated with placement of central venous catheters (CVCs) include bloodstream infections (BSIs), which cause increased length of stay in the intensive care unit (by 2.41 days) and longer length of hospital stay (by 7.54 days). Mortality rates attributed to CVC-BSIs range from 0% to 25%. Poor compliance with Centers for Disease Control and Prevention guidelines for the placement of CVCs may be one cause. In addition, the Centers for Medicare & Medicaid Services now list a CVC-associated infection as a preventable hospital-acquired infection. Despite these statistics and measures, compliance has not improved over the past 30 years. This goal of this study was to determine whether simulation combined with didactic training would improve sterile technique during ultrasound (US)-guided CVC insertion compared with didactic training alone among novices and whether after simulation training novices would perform similarly to experienced residents.