Use of an ultrasound-guided intravenous catheter insertion simulation-based mastery learning curriculum to improve paediatric anaesthesia care

Heather A Ballard; Adovich Rivera; Michelle Tsao; Mitch Phillips; Alison Robles; John Hajduk; Joe Feinglass; Jeffrey H Barsuk

doi:10.1016/j.bjao.2022.100101

Use of an ultrasound-guided intravenous catheter insertion simulation-based mastery learning curriculum to improve paediatric anaesthesia care

BJA Open. 2022 Oct 29:4:100101. doi: 10.1016/j.bjao.2022.100101. eCollection 2022 Dec.

Authors

Heather A Ballard¹, Adovich Rivera², Michelle Tsao¹, Mitch Phillips¹, Alison Robles¹, John Hajduk¹, Joe Feinglass³, Jeffrey H Barsuk³

Affiliations

¹ Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
² Institute of Public Health, Division of Health Services Outcomes Research, USA.
³ Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Abstract

Background: We previously showed that an ultrasound-guided i.v. catheter insertion (USGIV) simulation-based mastery learning (SBML) curriculum improves the simulated USGIV skills of paediatric anaesthesiologists. It remains unclear if improvements in simulated USGIV skills translate to improved patient care.

Methods: A cohort study was conducted from August 2018 to August 2020 to evaluate paediatric anaesthesiologists' USGIV performance in the operating theatre before and after they participated in the USGIV SBML curriculum. Paediatric anaesthesiologists' use of ultrasound for successful i.v. insertion and first-attempt i.v. insertion success rate with ultrasound were compared before and after training.

Results: Twenty-nine paediatric anaesthesiologists completed training. Unadjusted analysis showed a significant increase in the percentage of i.v. catheters inserted with ultrasound for successful i.v. catheter insertion (9.5-14.5%; P<0.001) and first i.v. catheter insertion attempt success with ultrasound (5.5-8.9%; P<0.001) from before to after training. Multivariable regression analysis showed higher odds of ultrasound use for a successful i.v. catheter attempt (1.79; 95% confidence interval [CI]: 1.11-2.90; P=0.018) and first-attempt success with ultrasound (4.11; 95% CI: 2.02-8.37; P<0.001) after training.

Conclusions: After completing the USGIV SBML curriculum, paediatric anaesthesiologists increased their ultrasound use for successful i.v. catheter insertion and first-attempt success rate with ultrasound for patients in the operating theatre.

Keywords: anaesthesiology/education; clinical competence; mastery learning; peripheral catheterisation; simulation training; ultrasonography/methods.