central venous catheter insertion train the trainer

Conditions: Healthy

Summary: the investigators previously successfully implemented a central venous catheter (cvc) simulation-based mastery learning (sbml) curriculum at northwestern university. as a result, trainee skill improved, complications, including central line associated bloodstream infections (clabsis) decreased and the curriculum was proven cost-effective. therefore the veterans administration medical centers (vamc) decided to implement this training at some of their sites as a quality improvement project. the investigators will train faculty at these locations to implement the same curriculum at their individual sites. outcome data will be collected to evaluate the outcomes of the quality improvement (qi) project (complications, infections, skills).

beginning in 2006, northwestern university internal medicine and emergency medicine residents completed simulation-based mastery learning in central venous catheter (cvc) insertion before clinical rotations in the medical intensive care unit (micu). this comprehensive program in central line training used repetitive practice and simulation technology to train residents to mastery standards. this study had important patient safety implications. this program resulted in improved trainee skill and reduced cvc insertion complications, including a significant decrease in the rate of central line associated bloodstream infections (clabsi). in addition, the investigators showed that the in cvc insertion was highly cost-effective suggesting that investment in simulation training can produce significant medical care cost savings. this curriculum has now been successfully implemented at a few other sites. due to the investigators' success, the va has requested that medical error reduction and certification, inc.(merci) along with northwestern university, implements the curriculum at its sites across the county as a quality improvement project. using a train the trainer course in cvc placement, the investigators are interested in analyzing the data that the vamc will provide to merci and studying the outcomes. four northwestern faculty completed a cvc insertion master trainer curriculum. one master trainer travels to each va facility in the program to facilitate a two-day train-the-trainer course on cvc insertion sbml. each va facility selects one or two "faculty champions" who complete cvc insertion sbml course and learn how to teach the curriculum on day 1 and are observed training and assessing peer healthcare providers at their institution on day 2. course materials include standardized videos and lectures, role-playing and practice with sample learners and cvc insertion assessments. in addition to the onsite master trainer, each va facility receives necessary training materials (standardized video lectures, data collection forms, assessment tools) and equipment (centrallineman simulators, ultrasound) to implement the curriculum at their institution. all participants complete pre and post testing and a course evaluation questionnaire. quantitative outcome data on learner skills and cvc insertion quality measures are collected to measure the overall success of the project.

Eligibility criteria:
inclusion criteria: 1. previously (or prospectively) collected de-identified data on trainee skill and experience 2. previously (or prospectively) collected de-identified data on patients in the va icu with cvcs 3. previously (or prospectively) collected de-identified data on mechanical complications in the icus exclusion criteria: 1. data not de-identified 2. data on pts on non-icu units 3. data on pts without cvcs

Keywords: central venous catheter simulation-based mastery learning medical education patient outcomes bloodstream infection due to central venous catheter pneumothorax inadvertent arterial puncture