Simulation training to improve aseptic non-touch technique and success during intravenous cannulation—effect on hospital-acquired blood stream infection and knowledge retention after 6 months: The snowball effect theory

Abstract

Background: Intravenous cannulation is a common procedure and a valuable skill in the neonatal intensive care unit. Standardized procedure and personnel training are needed in the unit to prevent hospital-acquired blood stream infections. Hence, we evaluated the effect of training using a low-fidelity simulation on the improvement of the aseptic non-touch technique during intravenous cannulation and knowledge retention after 6 months. Methods: The study was conducted in a tertiary care neonatal unit from June 2017 to July 2018. All the staff nurses and junior resident doctors posted in the neonatal intensive care were included in the study. A protocol and checklist score sheet was developed. The score sheet consisted of 23 items with a total score of 46. Participants were expected to obtain a minimum of 80%. A pre-test was conducted initially, followed by a formal training and then a post-test. The NITA newborn venous access mannequin was used to facilitate the training. A re-training for new nurses was conducted after 6 months. Data were analyzed using paired t-test. Results: A total of 29 doctors and nurses were enrolled in the training. The mean pre-test score was 29.93 compared to 42.66 in the post-test scores (mean difference 12.24(95% confidence interval: 9.39–16.05), p < 0.01. The mean scores were higher when the simulation was conducted after 6 months. There was a significant decline in blood stream infection rates from 5.5 to 1.65 per 1000 patient days (p = 0.05). Conclusion: Simulation-based training of health care personnel is a good modality to improve aseptic non-touch technique during intravenous cannulation in the neonatal intensive care unit. Simulation-based training also helps in knowledge retention and standardization of training procedures.

Remotely supervised ultrasound‐guided peripheral intravenous cannulation training: A prospective cohort study examining success rates and patient experience

“…However, aseptic technique was incorporated into simulation‐based training and required to be demonstrated before the beginning of live‐case training. Simulation‐based training in aseptic technique for PIVC insertion has been previously demonstrated to improve technique and knowledge retention 33 …”

“…Simulation-based training in aseptic technique for PIVC insertion has been previously demonstrated to improve technique and knowledge retention. 33 Supervisors and JMOs were contained within the same hospital, and results may not be generalisable to environments where both parties are not collocated. Also uncertain is the most beneficial timeframe to provide feedback to newly trained staff.…”

Design and content validation of a checklist about infection‐prevention performance of intensive care nurses in simulation‐based scenarios

“…Several studies have demonstrated the effectiveness of checklists for preventing VAP and CRB (Hernández‐Aceituno et al., 2020; Kellie et al., 2014; Li et al., 2018; Radhakrishnan et al., 2021; Wichmann et al., 2018), and some have even found a decrease in infection rates after implementing simulation‐based training (Balachander et al., 2021; Barsuk et al., 2015; Behzadi et al., 2019; Gerolemou et al., 2014). To date, we have only found one questionnaire that assesses both knowledge and skills in preventing VAP (Jansson et al., 2014).…”

Multidisciplinary simulation of local anaesthetic systemic toxicity improves diagnostic and treatment skills and self-confidence for pain clinic procedural staff

“…Team-based learning models using a simulated clinical environment have become part of the training of physicians and clinical staff. 7 8 Simulation provides a protected space for providers to test their individual knowledge and assess how well the team works in a replicated clinical scenario. It can help with the development and implementation of a crisis management plan where all team members effectively recognise their roles while managing rare clinical complications.…”