UCLA

Central venous catheter (CVC) placement is one of the most common yet invasive procedures in hospitals associated with significant morbidity, mortality, and financial burden. There is a paucity of literatures about graduating senior resident CVC performance in academic training hospitals. Baseline CVC performances of senior residents were measured, and the risk factors for poor performance were identified on a high fidelity CVC simulator. 28 of total 40 internal medicine senior residents within the last 2 months of residency training from 2010 and 2011 participated. 8 subjects forfeited the procedure before completion. Incorrect anatomical landmark identification and threading the guide-wire with excessive force on the first attempt were the two most predictive risk factors in predicting residents' poor CVC placement. Predictions and quantification of different patient safety outcome variables based on identified risk factors were made possible with various statistical models.