Abstract
BackgroundCentral 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.MethodsThirty 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.ResultsThe 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.ConclusionsPrepackaged 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.
Highlights
Central line catheter insertion is a complex task with a high cognitive load for novices
There are only two studies assessing the introduction of an all-inclusive central line kit at two different intensive care units [10,18]
We investigated whether the use of a prepackaged allinclusive central line catheter insertion kit by novices effectively reduces the number of procedural mistakes, procedure duration, breaches of aseptic technique, and improves adherence to the procedural algorithm
Summary
Central line catheter insertion is a complex procedure with a high cognitive load for novices. We assessed whether the use of prepackaged all-inclusive central line insertion kits reduces procedural mistakes during central line catheter insertion by novices. Central line catheter insertion is a complex task with a high cognitive load for novices. There are only two studies assessing the introduction of an all-inclusive central line kit at two different intensive care units [10,18]. In both studies, several changes were introduced simultaneously (checklists, staff education, and daily central line assessments). Neither study assessed the effect of prepackaged all-inclusive central line catheter kits in reducing mechanical complications or time resources. There was no differentiation between novices and experts
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