Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills

Annika Meyer,Andreas R Klatt,Jakob Schreiber,Christoph Stosch,Julian Brinkmann,Thomas Streichert

doi:10.1186/s12909-021-02868-5

Annika Meyer, Andreas R Klatt + Show 4 more

Open Access

https://doi.org/10.1186/s12909-021-02868-5

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Abstract

BackgroundThe American Association of Medical Colleges has defined peripheral intravenous cannulation as one of the eight practical skills that a medical student should possess upon graduation. Since following a standard hygiene protocol can reduce the rate of complications such as bloodstream infections, the medical student’s compliance to hygienic standards is highly relevant.MethodsThis unicentric longitudinal cohort study included 177 medical students undergoing OSCE 1 in the winter semesters 2016/2017 and 2017/2018 as well as OSCE 2 during the winter semesters 2018/2019 and 2019/2020 at the University of Cologne. Their performance in peripheral intravenous cannulation was rated by trained student supervisors using a scaled 13-item questionnaire and compared between OSCE 1 and OSCE 2.ResultsOverall, a decline in the correct placement of peripheral intravenous catheters was observed among advanced medical students during OSCE 2 (mean total score: 6.27 ± 1.84) in comparison to their results in OSCE 1 (mean total score: 7.67 ± 1.7). During OSCE 2, the students were more negligent in regard to hygienic behavior, such as disinfection of the puncture site as well as hand disinfection before and after venipuncture. Their patients were also less likely to be informed about the procedure as compared to OSCE 1.ConclusionsAn unsatisfying performance in regard to peripheral intravenous cannulation was observed in medical students with hygiene compliance deteriorating between the third and fifth year of their study. Thus, we promote an extension of practical hygiene and stress management training in medical school to reduce complications associated with intravenous catheters, such as bloodstream infections.

Highlights

The American Association of Medical Colleges has defined peripheral intravenous cannulation as one of the eight practical skills that a medical student should possess upon graduation
Hygiene compliance is especially insufficient in more advanced medical students
For over 20 years, the use of intravenous catheters such as peripheral intravenous catheter (PIV), has been determined as one of eight basic practical skills medical students should possess upon graduation by the American Association of Medical Colleges [1, 2]

Summary

Introduction

The American Association of Medical Colleges has defined peripheral intravenous cannulation as one of the eight practical skills that a medical student should possess upon graduation. For over 20 years, the use of intravenous catheters such as peripheral intravenous catheter (PIV), has been determined as one of eight basic practical skills medical students should possess upon graduation by the American Association of Medical Colleges [1, 2]. This is not surprising, since PIV is an established and frequently used method in the clinical practice with 150–330 million applications per year in the USA alone [3, 4]. Reducing the rate of nosocomial BSI would lessen BSI-associated mortality and morbidity risk, and reduce health care costs of up to $40,000 per case [9, 14, 15]

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