Developing a Tool to Assess Placement of Central Venous Catheters in Pediatrics Patients.

Journal Article

Pediatric critical care medicine requires the acquisition of procedural skills, but to date no criteria exist for assessing trainee competence in central venous catheter (CVC) insertion.The goal of this study was to create and demonstrate validity evidence for a direct observation tool for assessing CVC insertion.Ten experts used the modified Delphi technique to create a 15-item direct observation tool to assess 5 scripted and filmed simulated scenarios of CVC placement. The scenarios were hosted on a dedicated website from March to May 2013, and respondents recruited by e-mail completed the observation tool in real time while watching the scenarios. The goal was to obtain 50 respondents and a total of 250 scenario ratings.A total of 49 pediatrics intensive care faculty physicians (6.3% of 780 potential subjects) responded and generated 188 scenario observations. Of these, 150 (79.8%) were recorded from participants who scored 4 or more on the 5 scenarios. The tool correctly identified the expected reference standard in 96.8% of assessments with an interrater agreement kappa (standard error) = 0.94 (0.07) and receiver operating characteristic = 0.97 (95% CI 0.94-0.99).This direct observation assessment tool for central venous catheterization demonstrates excellent performance in identifying the reference standard with a high degree of interrater reliability. These assessments support a validity construct for a pediatric critical care medicine faculty member to assess a provider placing a CVC in a pediatrics patient.

Full Text

Duke Authors

Cited Authors

  • Fleming, GM; Mink, RB; Hornik, C; Emke, AR; Green, ML; Mason, K; Petrillo, T; Schuette, J; Tcharmtchi, MH; Winkler, M; Turner, DA

Published Date

  • July 2016

Published In

Volume / Issue

  • 8 / 3

Start / End Page

  • 346 - 352

PubMed ID

  • 27413436

Electronic International Standard Serial Number (EISSN)

  • 1949-8357

International Standard Serial Number (ISSN)

  • 1949-8349

Digital Object Identifier (DOI)

  • 10.4300/jgme-d-15-00365.1

Language

  • eng