Department of Surgery, 12338University of Texas Medical Branch, TX, USA.
Am Surg. 2022 Nov;88(11):2678-2685. doi: 10.1177/00031348211011134. Epub 2021 Apr 20.
Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE.
A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning "Cost and CLABSI," "Cost and Central line Associated Bloodstream Infections," and "Cost and Central Line" in their abstract and article body. Articles chosen for qualitative synthesis mentioned "simulation" in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis.
Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs.
Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.
中心静脉导管相关性血流感染（CLABSI）是可预防的并发症，对患者健康构成重大威胁，并给医院带来经济负担。文献中中心静脉导管模拟教育（SBE）的努力差异很大。本研究的目的是对已发表的中心静脉导管 SBE 进行价值分析，并开发一种研究中心静脉导管 SBE 的改良方法。
对 PubMed Central 和 Cumulative Index to Nursing and Allied Health Literature（CINAHL）数据库进行检索，检索内容为摘要和全文中提到“Cost and CLABSI”、“Cost and Central line Associated Bloodstream Infections”和“Cost and Central Line”的文章。选择进行定性综合分析的文章摘要和全文中提到“simulation”，并根据以下标准进行分析：SBE 前后的感染率、模拟成本、包括使用的模拟器模型在内的 SBE 设计以及学习者分析。
在确定的 215 篇文章中，分析了 23 篇，其中 10 篇（43.48%）讨论了中心静脉导管模拟的成本，报告成本的标准不同，8 篇（34.8%）用数字讨论了中心静脉导管并发症的发生率（7 例 CLABSI 和 1 例气胸），只有 3 篇（13%）同时讨论了这两个问题（图）。只有 1 篇文章讨论了真正的模拟成本（包括场地租金、设备启动成本和教师工资）及其对 CLABSI 的长期影响。
目前关于中心静脉导管 SBE 工作的文献缺乏价值主张。由于中心静脉导管 SBE 领域缺乏基于价值的数据，作者提出了一个成本报告标准，供未来报告中心静脉导管 SBE 成本的研究使用。
