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Current training in percutaneously inserted central catheter (PICC) placement and maintenance for neonatal–perinatal medicine fellows

Journal of Perinatology volume 40, pages 589–594 (2020)Cite this article

Subjects

Abstract

Objective

To describe the current educational status of percutaneously inserted central catheter (PICC) insertion/ maintenance training for neonatal–perinatal medicine (NPM) fellows in the United States.

Study design

A cross-sectional 34-question survey was electronically distributed to NPM fellowship training program directors (PDs) in the United States.

Results

The response rate was 81.8% (81/99 PD). Most PDs (68.5%) reported that their neonatal intensive care unit has a PICC team. Fellows were PICC team members in 72%. Only 52% of programs offer formal training in PICC placement to fellows; 61.5% of these utilize a standardized curriculum. Dedicated PICC team existence was negatively associated with formal training for PICC insertion and maintenance for fellows (42.0% with PICC team vs. 73.91% without, p = 0.01).

Conclusions

Wide variation exists in fellow’s exposure, education, and competency assessment in PICC-related activities nationally. Development of a standardized curriculum would be beneficial.

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References

  1. ACGME Common Program Requirements (Post-Doctoral Education Program). Accreditation Council for Graduate Medical Education (ACGME); 2018. p. 15–21.

  2. Downes KJ, Narendran V, Meinzen-Derr J, McClanahan S, Akinbi HT. The lost art of intubation: assessing opportunities for residents to perform neonatal intubation. J Perinatol. 2012;32:927–32.

    Article  CAS  Google Scholar 

  3. Haubner LY, Barry JS, Johnston LC, Soghier L, Tatum PM, Kessler D, et al. Neonatal intubation performance: room for improvement in tertiary neonatal intensive care units. Resuscitation. 2013;84:1359–64.

    Article  Google Scholar 

  4. Sawyer T, French H, Ades A, Johnston L. Neonatal-perinatal medicine fellow procedural experience and competency determination: results of a national survey. J Perinatol. 2016;36:570–4.

    Article  CAS  Google Scholar 

  5. Gozzo YF, Cummings CL, Chapman RL, Bizzarro MJ, Mercurio MR. Who is performing medical procedures in the neonatal intensive care unit? J Perinatol. 2011;31:206–11.

    Article  CAS  Google Scholar 

  6. DeMauro SB, Millar D, Kirpalani H. Noninvasive respiratory support for neonates. Curr Opin Pediatr. 2014;26:157–62.

    Article  Google Scholar 

  7. Gaies MG, Landrigan CP, Hafler JP, Sandora TJ. Assessing procedural skills training in pediatric residency programs. Pediatrics. 2007;120:715–22.

    Article  Google Scholar 

  8. Levit O, Shabanova V, Bizzarro M. Impact of a dedicated nursing team on central line-related complications in neonatal intensive care unit. J Matern Fetal Neonatal Med. 2019:1–5. https://doi.org/10.1080/14767058.2018.1555814.

  9. Taylor T, Massaro A, Williams L, Doering J, McCarter R, He J, et al. Effect of a dedicated percutaneously inserted central catheter team on neonatal catheter-related bloodstream infection. Adv Neonatal Care. 2011;11:122–8.

    Article  Google Scholar 

  10. Linck DA, Donze A, Hamvas A. Neonatal peripherally inserted central catheter team. Evolution and outcomes of a bedside-nurse-designed program. Adv Neonatal Care. 2007;7:22–29.

    Article  Google Scholar 

  11. Holzmann-Pazgal G, Kubanda A, Davis K, Khan AM, Brumley K, Denson SE. Utilizing a line maintenance team to reduce central-line-associated bloodstream infections in a neonatal intensive care unit. J Perinatol. 2012;32:281–6.

    Article  CAS  Google Scholar 

  12. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10 Suppl):S70–81.

    Article  Google Scholar 

  13. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Medical education featuring mastery learning with deliberate practice can lead to better health for individuals and populations. Acad Med. 2011;86:e8–9.

    Article  Google Scholar 

  14. Robinson MK, Mogensen KM, Grudinskas GF, Kohler S, Jacobs DO. Improved care and reduced costs for patients requiring peripherally inserted central catheters: the role of bedside ultrasound and a dedicated team. J Parenter Enter Nutr. 2005;29:374–9.

    Article  Google Scholar 

  15. Barsuk JH, McGaghie WC, Cohen ER, O’Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med. 2009;37:2697–701.

    PubMed  Google Scholar 

  16. Kessler DO, Auerbach M, Pusic M, Tunik MG, Foltin JC. A randomized trial of simulation-based deliberate practice for infant lumbar puncture skills. Simul Health. 2011;6:197–203.

    Article  Google Scholar 

  17. Wayne DB, Butter J, Siddall VJ, Fudala MJ, Wade LD, Feinglass J, et al. Mastery learning of advanced cardiac life support skills by internal medicine residents using simulation technology and deliberate practice. J Gen Intern Med. 2006;21:251–6.

    Article  Google Scholar 

  18. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86:706–11.

    Article  Google Scholar 

  19. Sawyer T, White M, Zaveri P, Chang T, Ades A, French H, et al. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine. Acad Med. 2015;90:1025–33.

    Article  Google Scholar 

  20. Johnston L, Sawyer T, Nishisaki A, Whitfill T, Ades A, French H, et al. Neonatal intubation competency assessment tool: development and validation. Acad Pediatr. 2019;19:157–64.

    Article  Google Scholar 

  21. Sharma D, Farahbakhsh N, Tabatabaii SA. Role of ultrasound for central catheter tip localization in neonates: a review of the current evidence. J Matern Fetal Neonatal Med. 2019;32:2429–37.

    Article  Google Scholar 

  22. Johnson KN, Thomas T, Grove J, Jarboe MD. Insertion of peripherally inserted central catheters in neonates less than 1.5 kg using ultrasound guidance. Pediatr Surg Int. 2016;32:1053–7.

    Article  Google Scholar 

  23. French H, Gray M, Gillam-Krakauer M, Bonachea EM, Carbajal M, Payne A, et al. Flipping the classroom: a national pilot curriculum for physiology in neonatal-perinatal medicine. J Perinatol. 2018;38:1420–7.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA

    Orly Levit, Veronika Shabanova, Matthew J. Bizzarro & Lindsay Johnston

  2. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA

    Veronika Shabanova

Authors
  1. Orly Levit
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  2. Veronika Shabanova
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  3. Matthew J. Bizzarro
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  4. Lindsay Johnston
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Contributions

OL designed the survey, collected the data and wrote the initial draft of the manuscript, contributed to subsequent revisions of the manuscript, and approved the final version. VS performed all statistical analyses, helped write and revise the manuscript, and approved the final version. MJB participated in the design of the survey, helped write and revise the manuscript, and approved the final version. LJ participated in the design of the survey, helped write and revise the manuscript, and approved the final version.

Corresponding author

Correspondence to Orly Levit.

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Levit, O., Shabanova, V., Bizzarro, M.J. et al. Current training in percutaneously inserted central catheter (PICC) placement and maintenance for neonatal–perinatal medicine fellows. J Perinatol 40, 589–594 (2020). https://doi.org/10.1038/s41372-019-0587-3

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