More than five million central lines are placed in patients who need prolonged drug delivery every year in the United States, but almost a million cases can lead to complications. To reduce infections, blood clots, and other complications associated with central line catheters, Penn State researchers developed online training paired with simulation exercises for trainee physicians, which was implemented in 2022. The training significantly reduced the prevalence of mechanical issues, infections, and blood clots compared to previous years, showcasing the effectiveness of the approach.
In a study published in the Journal of Surgical Education, researchers assessed the impact of the training on central line complication rates by comparing error rates from the years before and after the training was fully implemented. The results showed a notable decrease in all complication types after the training was launched, demonstrating the benefits of the new training method. The research team plans to expand this approach to other common procedures with high complication rates, such as colonoscopies and laparoscopic surgeries, to improve patient outcomes.
The traditional training method for central line placement and surgical procedures involves residents observing senior doctors, practicing on patients, and then teaching others. However, the simulation-based training developed by the Penn State researchers allows residents to practice the procedure multiple times without putting patients at risk. This new approach involves online training and simulation exercises for standardized ultrasound-guided internal jugular central venous catheterization, providing residents with a safer and more effective way to learn.
Residents first complete online training and then practice on a dynamic haptic robotic trainer that simulates real conditions and offers automated feedback. The training was initially conducted with 25 surgical residents at the Penn State Health Milton S. Hershey Medical Center and has since expanded to include all residents at Hershey and a partnership with Cedars-Sinai Medical Center in Los Angeles. To date, approximately 700 physicians have been trained using this method, with around 200 physicians trained annually.
By comparing error rates before and after the implementation of the simulation training, the researchers found a significant reduction in mechanical complications, infections, and blood clots associated with central line placement. The results show a clear improvement in error rates from 2016 and 2017 to 2022, indicating the effectiveness of the new training approach. The ultimate goal is to continue improving the system and expanding it to other hospitals to achieve zero errors in central line placement.
The study was conducted with the support of the U.S. National Science Foundation and the National Institutes of Health’s National Heart, Lung, and Blood Institute. The interdisciplinary work between engineers and clinicians at Penn State has led to innovative training methods that not only improve patient outcomes but also contribute to advancements in medical education and practice. The success of the simulation-based training for central line placement highlights the potential for applying similar approaches to other medical procedures to enhance physician proficiency and minimize risks to patient safety.
