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• W2058592852 abstract "The insertion of temporary hemodialysis catheters is considered to be a core competency of nephrology fellowship training. Little is known about the adequacy of training for this procedure and the extent to which evidence-based techniques to reduce complications have been adopted. We conducted a web-based survey of Canadian nephrology trainees regarding the insertion of temporary hemodialysis catheters. Responses were received from 45 of 68 (66%) eligible trainees. The median number of temporary hemodialysis catheters inserted during the prior 6 months of training was 5 (IQR, 2-11), with 9 (20%) trainees reporting they had inserted none. More than one-third of respondents indicated that they were not adequately trained to competently insert temporary hemodialysis catheters at both the femoral and internal jugular sites. These findings are relevant to a discussion of the current adequacy of procedural skills training during nephrology fellowship. With respect to temporary hemodialysis catheter placement, there is an opportunity for increased use of simulation-based teaching by training programs. Certain infection control techniques and use of real-time ultrasound should be more widely adopted. Consideration should be given to the establishment of minimum procedural training requirements at the level of both individual training programs and nationwide certification authorities. The insertion of temporary hemodialysis catheters is considered to be a core competency of nephrology fellowship training. Little is known about the adequacy of training for this procedure and the extent to which evidence-based techniques to reduce complications have been adopted. We conducted a web-based survey of Canadian nephrology trainees regarding the insertion of temporary hemodialysis catheters. Responses were received from 45 of 68 (66%) eligible trainees. The median number of temporary hemodialysis catheters inserted during the prior 6 months of training was 5 (IQR, 2-11), with 9 (20%) trainees reporting they had inserted none. More than one-third of respondents indicated that they were not adequately trained to competently insert temporary hemodialysis catheters at both the femoral and internal jugular sites. These findings are relevant to a discussion of the current adequacy of procedural skills training during nephrology fellowship. With respect to temporary hemodialysis catheter placement, there is an opportunity for increased use of simulation-based teaching by training programs. Certain infection control techniques and use of real-time ultrasound should be more widely adopted. Consideration should be given to the establishment of minimum procedural training requirements at the level of both individual training programs and nationwide certification authorities. Training Can Be Cost-Effective in Reducing Morbidity Associated With Temporary Hemodialysis Catheter InsertionAmerican Journal of Kidney DiseasesVol. 63Issue 2PreviewWe agree with Clark et al1 that robust training is necessary to reduce temporary hemodialysis catheter complications. Our tertiary-care renal unit manages 630 prevalent and 150 incident hemodialysis patients annually, delivering ∼1% of hemodialysis sessions by temporary hemodialysis catheters. Significant morbidity, excess hospitalization, and high cost are attributable to this population, often related to hemodialysis-associated Staphylococcus aureus bacteremia (SAB; Table 1). To address this problem, we developed a quality improvement initiative that included formal training for all individuals placing temporary hemodialysis catheters on evidence-based aseptic technique, real-time ultrasound guidance, and application of chlorhexidine-impregnated patches to temporary hemodialysis catheter exit sites. Full-Text PDF" @default.
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• W2058592852 date "2013-09-01" @default.
• W2058592852 modified "2023-09-30" @default.
• W2058592852 title "Temporary Hemodialysis Catheter Placement by Nephrology Fellows: Implications for Nephrology Training" @default.
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• W2058592852 doi "https://doi.org/10.1053/j.ajkd.2013.02.380" @default.
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