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Creating and evaluating a data-driven curriculum for central venous catheter placement.

James R Duncan, Katherine Henderson, Mandie Street

Journal of Graduate Medical Education

|October 7, 2011

Summary

Failure Mode and Effects Analysis (FMEA) improved central venous catheter training, significantly reducing retained guidewires. This standardized curriculum shows promise for enhancing patient safety in catheter placement procedures.

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Area of Science:

Medical Education
Patient Safety
Quality Improvement

Background:

Central venous catheter placement is a common procedure with a high error rate.
Failure Mode and Effects Analysis (FMEA) is a tool used in high-reliability fields to improve quality and safety.

Purpose of the Study:

To develop a standardized curriculum for central venous catheter training using FMEA.
To identify and address high-priority failure modes in central venous catheter placement.

Main Methods:

A multidisciplinary team used FMEA to analyze potential errors in central venous catheter placement.
Developed online and hands-on training modules focusing on identified failure modes.
Assessed intern progress through multiple evaluations after curriculum implementation.

Main Results:

New interns demonstrated limited prior experience with central venous catheter procedures.
FMEA identified retained guidewires, needle access, and catheter-associated infections as priority areas.
The curriculum led to a more than four-fold decrease in retained guidewires. Infection rates have not yet shown a decline.

Conclusions:

FMEA provided a structured process for developing a targeted central venous catheter training curriculum.
The curriculum significantly reduced retained guidewire complications.
While infection rates require further monitoring, the FMEA approach shows promise for improving patient safety.