title: Prepackaged central line kits reduce procedural mistakes during central line insertion: a randomized controlled prospective trial.
abstract: BACKGROUND
  Central line catheter insertion is a complex procedure with a high cognitive load for novices. Providing a prepackaged all-inclusive kit is a simple measure that may reduce the cognitive load. We assessed whether the use of prepackaged all-inclusive central line insertion kits reduces procedural mistakes during central line catheter insertion by novices.
  
  
  METHODS
  Thirty final year medical students and recently qualified physicians were randomized into two equal groups. One group used a prepackaged all-inclusive kit and the other used a standard kit containing only the central vein catheter and all other separately packaged components provided in a materials cart. The procedure was videotaped and analyzed by two blinded raters using a checklist. Both groups performed central line catheter insertion on a manikin, assisted by nursing students.
  
  
  RESULTS
  The prepackaged kit group outperformed the standard kit group in four of the five quality indicators: procedure duration (26:26 ± 3:50 min vs. 31:27 ± 5:57 min, p = .01); major technical mistakes (3.1 ± 1.4 vs. 4.8 ± 2.6, p = .03); minor technical mistakes (5.2 ± 1.7 vs. 8.0 ± 3.2, p = .01); and correct steps (83 ± 5% vs. 75 ± 11%, p = .02). The difference for breaches of aseptic technique (1.2 ± 0.8 vs. 3.0 ± 3.6, p = .06) was not statistically significant.
  
  
  CONCLUSIONS
  Prepackaged all-inclusive kits for novices improved the procedure quality and saved staff time resources in a controlled simulation environment. Future studies are needed to address whether central line kits also improve patient safety in hospital settings.
authors: University of Tuebingen Medical School, Tuebingen, Germany.
authors: Yelena
authors: Y
authors: Fenik
authors: Nora
authors: N
authors: Celebi
authors: Robert
authors: R
authors: Wagner
authors: Christoph
authors: C
authors: Nikendei
authors: Frederike
authors: F
authors: Lund
authors: Stephan
authors: S
authors: Zipfel
authors: Reimer
authors: R
authors: Riessen
authors: Peter
authors: P
authors: Weyrich
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D062905:Central Venous Catheters / Q000009:adverse effects; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D019300:Medical Errors / Q000517:prevention & control*; D016037:Single-Blind Method; D014741:Video Recording
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