title: Reduced variability and execution time to reach a target with a needle GPS system: Comparison between physicians, residents and nurse anaesthetists.
abstract: Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle guidance positioning systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS. We measured execution times to perform the tasks, hand-eye coordination and the number of repositioning occurrences or errors in handling the needle or the probe. Without the GPS system, we observed a significant inter-individual difference for execution time (P<0.05), hand-eye coordination and the number of errors/needle repositioning between physicians, residents and nurse anaesthetists. US training and video gaming were found to be independent factors associated with a shorter execution time. Use of GPS attenuated the inter-individual and group variability. We observed a reduced execution time and improved hand-eye coordination in all groups as compared to US without GPS. Neither US training, video gaming nor demographic personal or professional factors were found to be significantly associated with reduced execution time when GPS was used. US associated with GPS systems may improve safety and decrease execution time by reducing inter-individual variability between professionals for needle-handling procedures.
authors.affiliation: Pôle Anesthésie Réanimation, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Fevre
authors.affiliation: Pôle Pharmacie, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vincent
authors.affiliation: Pôle Anesthésie Réanimation, CHU de Grenoble, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Picard
authors.affiliation: Pôle Anesthésie Réanimation, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Vighetti
authors.affiliation: Pôle Pharmacie, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Chapuis
authors.affiliation: Pôle Pharmacie, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Detavernier
authors.affiliation: Pôle Pharmacie, CHU de Grenoble, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France; Inserm CIC 1406, 38000 Grenoble, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
authors.affiliation: Pôle Anesthésie Réanimation, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Payen
authors.affiliation: Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France; Inserm CIC 1406, 38000 Grenoble, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bosson
authors.affiliation: Pôle Anesthésie Réanimation, CHU de Grenoble, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France; Inserm CIC 1406, 38000 Grenoble, France. Electronic address: PAlbaladejo@chu-grenoble.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Albaladejo
mesh_terms: D000328:Adult; D000072080:Anesthesiologists; D002983:Clinical Competence; D003422:Critical Care; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009339:Needles; D009719:Nurse Anesthetists; D000070659:Patient Comfort; D061214:Patient Safety; D019047:Phantoms, Imaging; D010820:Physicians; D011446:Prospective Studies; D011597:Psychomotor Performance; D018910:Video Games
keywords: Central venous access; Healthcare professionals; Needle positioning system; Regional anaesthesia; Video game