Use of simulation-based education to reduce catheter-related bloodstream infections

Arch Intern Med. 2009 Aug 10;169(15):1420-3. doi: 10.1001/archinternmed.2009.215.


Background: Simulation-based education improves procedural competence in central venous catheter (CVC) insertion. The effect of simulation-based education in CVC insertion on the incidence of catheter-related bloodstream infection (CRBSI) is unknown. The aim of this study was to determine if simulation-based training in CVC insertion reduces CRBSI.

Methods: This was an observational education cohort study set in an adult intensive care unit (ICU) in an urban teaching hospital. Ninety-two internal medicine and emergency medicine residents completed a simulation-based mastery learning program in CVC insertion skills. Rates of CRBSI from CVCs inserted by residents in the ICU before and after the simulation-based educational intervention were compared over a 32-month period.

Results: There were fewer CRBSIs after the simulator-trained residents entered the intervention ICU (0.50 infections per 1000 catheter-days) compared with both the same unit prior to the intervention (3.20 per 1000 catheter-days) (P = .001) and with another ICU in the same hospital throughout the study period (5.03 per 1000 catheter-days) (P = .001).

Conclusions: An educational intervention in CVC insertion significantly improved patient outcomes. Simulation-based education is a valuable adjunct in residency education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / prevention & control*
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling / microbiology*
  • Chicago
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Cross-Sectional Studies
  • Curriculum
  • Emergency Medicine / education
  • Hospitals, Teaching
  • Humans
  • Intensive Care Units
  • Internal Medicine / education
  • Internship and Residency*
  • Models, Anatomic*
  • Treatment Outcome