title: Simulation-Based Mastery Learning Improves Central Line Maintenance Skills of ICU Nurses.
abstract: OBJECTIVE
  This study evaluated the impact of a simulation-based mastery learning (SBML) curriculum on central line maintenance and care among a group of ICU nurses.
  
  
  METHODS
  The intervention included 5 tasks: (a) medication administration, (b) injection cap (needleless connector) changes, (c) tubing changes, (d) blood drawing, and (e) dressing changes. All participants underwent a pretest, engaged in deliberate practice with directed feedback, and completed a posttest. We compared pretest and posttest scores and assessed correlations between demographics, self-confidence, and pretest performance.
  
  
  RESULTS
  The number of nurses passing each task at pretest varied from 24 of 49 (49%) for dressing changes to 44 of 49 (90%) for tubing changes. At pretest, scores ranged from a median of 0.0% to 73.1%. At posttest, all scores rose to a median of 100.0%. Total years in nursing and ICU nursing had significant, negative correlations with medication administration pretest performance (r = -0.42, P = .003; r = -0.42, P = .003, respectively).
  
  
  CONCLUSIONS
  ICU nurses displayed large variability in their ability to perform central line maintenance tasks. After SBML, there was significant improvement, and all nurses reached a predetermined level of competency.
authors.affiliation: Author Affiliations: Associate Professor of Medicine and Director of Simulation and Patient Safety (Dr Barsuk), Research Associate (Ms Cohen), and Vice Dean of Education and Dr John Sherman Appleman Professor of Medicine (Dr Wayne), Department of Medical Education, Northwestern University Feinberg School of Medicine; and Infection Preventionist (Ms Mikolajczak), Nurse Education Consultant (Ms Seburn), and Vice President of Operations and Associate Chief Nurse Executive (Ms Slade), Department of Nursing, Northwestern Memorial Hospital, Chicago, Illinois.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Barsuk
authors.forename: Elaine R
authors.initials: ER
authors.lastname: Cohen
authors.forename: Anessa
authors.initials: A
authors.lastname: Mikolajczak
authors.forename: Stephanie
authors.initials: S
authors.lastname: Seburn
authors.forename: Maureen
authors.initials: M
authors.lastname: Slade
authors.forename: Diane B
authors.initials: DB
authors.lastname: Wayne
mesh_terms: D055499:Catheter-Related Infections / Q000451:nursing / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000451:nursing* / Q000592:standards; D062905:Central Venous Catheters / Q000009:adverse effects / Q000592:standards*; D057189:Checklist; D003198:Computer Simulation; D064648:Critical Care Nursing / Q000193:education* / Q000379:methods; D004509:Education, Nursing, Continuing / Q000379:methods / Q000592:standards; D004521:Educational Measurement / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008348:Manikins; D017145:Models, Educational; D061214:Patient Safety / Q000592:standards*; D015397:Program Evaluation