No abstract

According to the National Cancer Institute, ovarian cancer is the sixth most common cancer in women and the leading cause of death from gynecologic malignancies. Most often the disease is advanced before symptoms are evident. It is estimated that only 15% to 30% of women in advanced stages will survive 5 years, whereas, of women in stage I at the time of diagnosis, 95% are likely to be alive in 5 years, and most are cured following surgery. Current screening techniques recommended for women with known strong risk factors include combination transvaginal sonography with cancer antigen (CA-125). Transvaginal sonography and serum CA-125 have limited diagnostic predictability. A new early detection method that uses proteomic technology will soon be available. The OvaCheck test, as researchers purport, is a highly specific and sensitive early detection method for ovarian cancer in women with strong risk factors. The Food and Drug Administration has yet to approve nationwide marketing of OvaCheck for early detection, because trials are not yet complete. Anticipated commercial availability is scheduled for early 2005.

Introduction/Background: Healthcare worker (HCW) needlestick injuries (NSI) are associated with significant psychological stress for the provider. In addition, hospitals incur significant costs from occupational health testing, prophylaxis and follow-up that must be implemented for HCW NSI. The StatLock device is needleless safety engineered device (NSED) that uses an adhesive rather than sharps to secure a central venous catheter (CVC). The purpose of the study was to compare the effectiveness of live simulation practice to video instruction via a RCT to educate resident physicians to apply the alternative NSED to secure CVCs for future clinical use. Our hypothesis was that participants in the simulation based training group, (SBT) would be more likely to use the NSED to secure CVC and therefore sustain fewer NSIs as compared to the video (video) instruction group.Methods: Ninety five physicians likely to place CVCs during their training were enrolled in a randomized prospective longitudinal study to compare SBT to video instruction to teach HCW how to apply the alternative NSED. The SBT group was trained via active simulation practice to apply the device and allowed to practice until mastery. The video group watched the product video and participated in a question and answer session. All were queried regarding their prior knowledge and use of the NSED device and compensated if they returned in twelve months for a follow-up use questionnaire. NSI injury rates were monitored by the Division of Occupational Health and Safety within the institution and informed consent was given to view participants NSI records.Results: A total of 70 (81%), group participants completed the 12 month follow-up. The follow-up rates for the SBT and video groups were 95.6% and 67.3% respectively, indicating that those in the SBT group were more likely to return for 12 month follow up; p <0.001. Participants in the SBT group used the NSED more often in clinical practice n=22, as compared to video control group, n=8; p=0.034. There were a total of nine needlestick injuries to study subjects in the twelve month follow period. Five out of 9 (56%) of injuries occurred while suturing central lines. None of the injuries occurred while using the NSED device.Conclusion: Simulation trained HCW were more likely to adapt the use of alternative safety device to suture CVC in clinical practice. There was a 1 in 200 incidence of NSI to HCW while suturing CVC. Therefore, the potential number needed to treat (NNT) to prevent a single HCW NSI is 200 uses of the NSED. This study was underpowered to detect any differences in injury types or rates between the SBT and video groups. Future larger sample size studies are needed to determine if SBT to use this device will prevent HCW NSI.Introduction/Background: Nursing faculty are embracing simulation as an active teaching strategy to augment traditional classroom and clinical pedagogies, 1,2 but a gap remains in what is known about learning in simulation and if that learning transfers to the clinical setting....