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Simulation-based paediatric intensive care unit central venous line maintenance bundle training

Kiran B Hebbar1, Charlene Cunningham2, Courtney McCracken3

  • 1Children's Healthcare of Atlanta at Egleston, United States; Emory University School of Medicine, United States.

Intensive & Critical Care Nursing
|December 4, 2014
PubMed

Insights

Simulation-based training for central venous line (CVL) care significantly improved maintenance bundle compliance in a pediatric intensive care unit (PICU). This enhanced practice was linked to a reduction in catheter-associated bloodstream infections (CA-BSIs).

Area of Science:

  • Pediatric Intensive Care
  • Infection Prevention and Control
  • Nursing Education and Practice

Background:

  • Improving compliance with central venous line (CVL) maintenance bundles can reduce catheter-associated bloodstream infections (CA-BSIs) in pediatric patients.
  • Nursing competency in CVL care is crucial for effective infection control in the pediatric intensive care unit (PICU).

Purpose of the Study:

  • To enhance maintenance bundle compliance rates for central venous lines (CVLs) in a PICU.
  • To improve nursing competency in central venous line (CVL) care through simulation-based training.

Main Methods:

  • A multidisciplinary team developed a bedside simulation-based training program for CVL maintenance bundle care.
  • A randomized comparison study assessed bedside PICU nurses, comparing standard training to simulation-based training with refresher sessions.
  • Compliance with the CVL maintenance bundle was measured using a standardized CVL score.

Main Results:

  • The intervention group (simulation-based training) showed significantly higher CVL bundle compliance scores than the control group at twelve months (p<0.0001).
  • The most substantial increase in CVL scores for the intervention group occurred within the first three months.
  • Catheter-associated bloodstream infection (CA-BSI) rates in the PICU decreased significantly following the intervention (p=0.034).

Conclusions:

  • Bedside simulation-based training effectively improves compliance with CVL maintenance bundle practices.
  • Enhanced adherence to CVL maintenance bundles is associated with a reduction in CA-BSI rates, highlighting the importance of this training method.
Abstract

Keywords:
Blood stream infectionBundleCentral linePaediatricSimulation

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