Seth Nikhil, Tran Phi, Ghauri Arshad, Sikka Anika, Metting Austin, Martinez George
Central Texas Veterans Affairs Hospital, Temple.
Baylor Scott & White Health, Irving, Texas.
Fed Pract. 2024 Feb;41(2):48-51. doi: 10.12788/fp.0449. Epub 2024 Feb 12.
Competency in paracentesis is an important procedural skill for health care practitioners caring for patients with decompensated cirrhosis. It is estimated that 97,577 paracentesis procedures were performed between 2010 and 2012 across 120 academic medical centers and 290 affiliated hospitals.
Due to limitations of resources at the Central Texas Veterans Affairs Hospital, a paracentesis clinic was created to give patients improved access to this procedure which is staffed by a supervising physician and internal medicine residents. We evaluated resident competency via survey and change in the number of paracentesis procedures performed with the utilization of this clinic.
Thirty-three residents completed the survey. The total mean number of paracentesis sessions participated in was 4.8. It was found that during training, 79% met conditional independence in performing this procedure with a high level of comfort by rotating through this clinic. It was also found that the number of procedures performed by internal medicine residents significantly increased with the addition of this clinic.
A dedicated paracentesis clinic with internal medicine resident involvement can increase resident paracentesis procedural independence, the number of procedures available and performed, and procedural comfort level by the end of training.
腹腔穿刺术技能对于照顾失代偿期肝硬化患者的医护人员而言是一项重要的操作技能。据估计，2010年至2012年间，120家学术医疗中心和290家附属医院共进行了97,577例腹腔穿刺术。
由于德克萨斯中部退伍军人事务医院资源有限，因此设立了一个腹腔穿刺术诊所，以便患者能更方便地接受该操作，该诊所由一名主治医生和内科住院医师负责。我们通过调查以及利用该诊所后腹腔穿刺术操作数量的变化来评估住院医师的技能水平。
33名住院医师完成了调查。参与腹腔穿刺术的总平均次数为4.8次。结果发现，在培训期间，79%的住院医师通过在该诊所轮转，在进行此项操作时达到了条件独立性，且操作舒适度较高。还发现，增设该诊所后内科住院医师的操作数量显著增加。
有内科住院医师参与的专门腹腔穿刺术诊所可提高住院医师腹腔穿刺术的操作独立性、可操作和已操作的数量，并在培训结束时提高操作舒适度。
