Simulation-Based Training for Nurses in Sterile Techniques During Central Vein Catheterization

Abstract

Background The effectiveness of simulation-based training of critical care nurses in sterile techniques has not been determined. Objective To evaluate the effectiveness of simulation-based training of critical care nurses to use sterile techniques during central vein catheterization and the effect of such training on infection rates. Methods A prospective controlled study with 12-month observational follow-up to assess the rate of catheter-related bloodstream infections in a 23-bed medical, surgical, neurological critical care unit. Results Forty-six critical care nurses completed assessment and training in sterile technique skills in the simulation laboratory. Performance scores at baseline were poor: median scores in each category ranging from 0 to 2 out of a maximum score of 4 and a median total score of 7 out of a maximum score of 24. After simulation-based training, nurses' median scores in each ST category and their total scores improved significantly, with the median total score increasing to 23 (P < .01; median difference, 15; 95% CI, 14-16). After completion of the simulation-based training intervention, the mean infection rate in the unit was reduced by 85% from 2.61 to 0.4 infections per 1000 catheterdays (P = .02). The incidence rate-ratio derived from the Poisson regression (0.15; 95% CI, 0.03-0.78) indicates an 85% reduction in the incidence of catheter-related bloodstream infections in the unit after the intervention. Conclusion Simulation-based training of critical care nurses in sterile technique is an important component in the strategy to reduce the occurrence of such infections and promote patient safety.

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

“…Evaluation of the evidence from 15 studies (five interrupted case series [25][26][27][28][29], five qualitative [24,[30][31][32][33], two controlled before-after [34,35], two non-controlled before-after [36,37], and one mixed methods [38]) showed that IPC education that involves frontline health care workers in a practical, hands-on approach and incorporates individual experiences is associated with decreased HAI and increased hand hygiene compliance. Twelve studies were from high-income countries [24-28, 31-34, 36-38], two from one upper-middleincome country [29,35], and one from a LMIC [30].…”

Does Simulation Training for Acute Care Nurses Improve Patient Safety Outcomes: A Systematic Review to Inform Evidence‐Based Practice

“…Reporting format of experience levels was disparate. Eight studies included samples of nurses with varying experience levels, ranging from <1 year to over 25 years of experience (Ballangrud, Hall‐Lord, Hedelin, & Persenius, ; Gerolemou et al, ; Kim, ; Klipfel et al, ; Liaw et al, ; Pati, Cason, Harvey, Evans, & Erwin, ; Trbovich, Pinkney, Cafazzo, & Easty, ; Wilson et al, ). One study was limited to inexperienced or entry‐level nurses with <2 years of experience (Roots, Thomas, Jaye, & Birns, ).…”

“…The study designs of the included research studies were pilot studies (Roots et al, ; Wilson et al, ), quasi‐experimental study designs with either a one group pretest posttest design (Ballangrud et al, ; Braddock et al, ; Gerolemou et al, ; Klipfel et al, ; Liaw et al, ) or a nonrandom assignment to groups (Kim, ; Nevo et al, ; Pati et al, ; Raurell‐Torreada et al, ; Trbovich et al, ). Sample sizes ranged from N = 6 to 247 RNs, and the mean sample size was N = 70 RNs.…”

“…Braddock et al () allowed one or more repetitions at the RN’s discretion; 43% participated in two or more sessions over the intervention period. Gerolemou et al’s () study incorporated two repetitions. Both the headwall study (Pati et al, ) and the intravenous (IV) pump technology study simulations (Trbovich et al, ) were unique because simulations were repeated 27 times per nurse.…”

The effect of simulator use on students' skill enhancements

“…In Gerolemou et al (2014), the ability of the nurse to apply sterile techniques in the central ven catheterization procedure was evaluated. Six basic elements were used for the catheterization criteria and the skills of the students were evaluated.…”