Tokumine Joho, Yorozu Tomoko, Moriyama Kiyoshi, Suzuki Teruko, Okada Chikako
Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Sinkawa, Mitaka, Tokyo, 181-8611, Japan.
Safe Central Venous Catheter Placement and Management Committee, Kyorin University Hospital, 6-20-2 Sinkawa, Mitaka, Tokyo, 181-8611, Japan.
BMC Med Educ. 2025 Jan 28;25(1):131. doi: 10.1186/s12909-025-06739-1.
Central venous catheter placement has been associated with mechanical complications, some of which can be life-threatening. Recent studies have shown that simulation-based education on ultrasound-guided central venous catheter placement improves puncture success rates; however, its effect on reducing mechanical complications remains unclear. This observational study examined how outcome-based simulation training for ultrasound-guided central venous catheter placement affects the incidence of mechanical complications in a clinical setting.
The Safe Central Venous Catheter Placement and Management Committee established a reporting system to monitor central venous catheter placement. In 2016, a skill assessment of ultrasound-guided central venous catheter placement was conducted. Outcome-based simulation training was introduced in 2017. Skills were evaluated using the skill assessment tool developed by the Japanese Society for Medical Simulation.
After implementing skill assessment and outcome-based simulation training, the mechanical complication rate decreased from 2.2% in 2015 to 1.2% in 2023.
A recent meta-analysis reported a 2.3% mechanical complication rate during ultrasound-guided central venous catheter placement. In comparison, the 1.2% complication rate at our institution is notably lower. This study suggests that outcome-based simulation training for ultrasound-guided central venous catheter placement may help reduce the incidence of mechanical complications in clinical settings.
中心静脉导管置入与机械性并发症相关，其中一些可能危及生命。最近的研究表明，基于模拟的超声引导下中心静脉导管置入培训可提高穿刺成功率；然而，其对减少机械性并发症的效果仍不明确。这项观察性研究探讨了基于结果的超声引导下中心静脉导管置入模拟培训如何影响临床环境中机械性并发症的发生率。
安全中心静脉导管置入与管理委员会建立了一个报告系统来监测中心静脉导管置入情况。2016年，对超声引导下中心静脉导管置入进行了技能评估。2017年引入了基于结果的模拟培训。使用日本医学模拟学会开发的技能评估工具对技能进行评估。
实施技能评估和基于结果的模拟培训后，机械性并发症发生率从2015年的2.2%降至2023年的1.2%。
最近的一项荟萃分析报告称超声引导下中心静脉导管置入期间机械性并发症发生率为2.3%。相比之下，我们机构1.2%的并发症发生率明显更低。这项研究表明，基于结果的超声引导下中心静脉导管置入模拟培训可能有助于降低临床环境中机械性并发症的发生率。
