Video-assisted structured teaching to improve aseptic technique during neuraxial block

Area of Science:

• Medical Education
• Infection Control
• Anesthesiology

Background:

• Epidural catheter insertion training often prioritizes manual dexterity over aseptic technique.
• Aseptic technique in epidural procedures frequently remains suboptimal despite increasing operator experience.

Purpose of the Study:

• To compare aseptic technique performance in novice operators after a targeted teaching intervention versus those trained prior to the intervention.
• To evaluate the effectiveness of a procedure-specific aseptic technique teaching module for epidural catheter insertion.

Main Methods:

• Two groups of second-year anesthesia residents (pre- and post-intervention) were videotaped during epidural procedures.
• Trained, blinded examiners assessed aseptic technique using a task-specific checklist, yielding scores from 0-30 points.
• Inter-rater reliability for aseptic technique scoring was high (intraclass correlation coefficient = 0.90).

Main Results:

• Median aseptic technique scores were significantly higher in the post-intervention group (27.58) compared to the pre-intervention group (16.56).
• Improved scores were observed across all experience levels (low, moderate, high) within the rotation period.
• 86 sessions involving 29 residents were analyzed.

Conclusions:

• Procedure-specific aseptic technique teaching, incorporating video assessment and demonstration, substantially improves aseptic practices in novice trainees.
• This targeted approach is more effective than traditional training methods for enhancing sterile technique during epidural catheter insertion.
• Further research should investigate long-term retention of aseptic skills in more senior residents.