Use of simulation-based education to reduce catheter-related bloodstream infections.
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.
Barsuk
Jeffrey H
JH
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. jbarsuk@northwestern.edu
Cohen
Elaine R
ER
Feinglass
Joe
J
McGaghie
William C
WC
Wayne
Diane B
DB
D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology*; D002641:Chicago; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008953:Models, Anatomic; D016896:Treatment Outcome