Simulation and patient safety: evaluative checklists for central venous catheter insertion.
In the advent of concerns for patient safety, simulation training is emerging as a method to train healthcare providers to perform invasive procedures such as central venous catheter (CVC) insertion while minimising harmful complications to the patient. New technologies in medical simulation have begun to shift research attention to the performance component of clinical competency. Accurate assessment of healthcare provider competence is a major priority in medical education necessitating the development of valid and reliable assessment tools. In the past year alone, nine evaluative tools, both global rating scales and procedural checklists, have been published in the research literature to evaluate the insertion of CVCs. A review of the advantages of published evaluation tools helps inform users with regard to the critical components necessary for a checklist. Ease of use, ability to be completed by a non-expert, categorical breakdown of critical actions involved in CVC insertion and the need for a comprehensive stepwise procedural checklist are discussed. The development of an ideal checklist may improve future competency-based training and performance evaluation in the clinical setting. A more thorough understanding of the status of checklists as evaluation tools in assessing performance of invasive procedures will lead to better training protocols and ultimately to improved patient safety.
Evans
Leigh V
LV
Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, USA. leigh.evans@yale.edu
Dodge
Kelly L
KL
D002405:Catheterization, Central Venous; D057189:Checklist / Q000592:standards*; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate; D017408:Guidelines as Topic; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D061214:Patient Safety; D015397:Program Evaluation; D015203:Reproducibility of Results; D017751:Safety Management / Q000379:methods*