J Pediatr Intensive Care 2018; 07(01): 039-042
DOI: 10.1055/s-0037-1604153
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Effect of Clinical Experience on the Learning Curve of Pediatric Intensive Care Unit Residents for the Central Venous Catheter Placement Procedure

Norihiko Tsuboi
1  Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
,
Michiko Abe
1  Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
,
Shotaro Matsumoto
1  Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
,
Nao Nishimura
1  Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
,
Satoshi Nakagawa
1  Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
› Author Affiliations
Funding None.
Further Information

Publication History

10 April 2017

03 June 2017

Publication Date:
06 July 2017 (eFirst)

Abstract

The objective of this study is to ascertain the effect of clinical experience on pediatric intensive care unit (PICU) residents' learning curve for central venous catheter placement in critically ill children. It was a 58-month retrospective observational study. The setting was multivalent PICU with 20 beds at a tertiary children's hospital. The subjects were PICU residents undergoing training in central venous catheter placement. During the study period, 22 residents were enrolled in the study, and 1,157 catheter placement procedures (485 central venous, 605 peripherally inserted central venous, 57 hemodialysis, and 10 “other” types of catheter placement procedures) were analyzed. The total success rate was 82.7%. After ultrasound-guided training simulation in catheter placement, the residents' learning curve for the procedure rose from 71% in the clinical setting at the first trial to 75% at the fourth trial and 80% by the 24th trial. Significant positive correlation was found between procedure success and number of trials with a Spearman coefficient (p  <  0.019). Adequate clinical experiences were necessary for PICU residents to achieve competency in central venous catheter placement in critically ill children.

Note

This study was performed at the National Center for Child Health and Development, Tokyo, Japan.