Outcomes Associated With Insertion of Indwelling Urinary Catheters by Medical Students in the Operating Room Following Implementation of a Simulation-Based Curriculum. (March 2020)

• Record Type: Journal Article
• Authors: Barnum, Trevor; Tatebe, Leah C.; Halverson, Amy L.; Helenowski, Irene B.; Yang, Anthony D.; Odell, David D.
• Is Part Of: Academic medicine. Volume 95:Number 3(2020)
• Publication Date: 2020-03
• Subjects: Medical education -- Periodicals; Medical policy -- Periodicals; Medical personnel -- Periodicals; Periodicals; 610.711
• DOI: 10.1097/ACM.0000000000003052
• Languages: English
• ISSNs: 1040-2446

Abstract

Abstract : Purpose: Catheter-associated urinary tract infection (CAUTI) is a priority quality metric for hospitals. The impact of placement of indwelling urinary catheter (IUC) by medical students on CAUTI rates is not well known. This study examined the impact of a simulation-based medical student education curriculum on CAUTI rates at an academic medical center. Method: Patient characteristics, procedural data, and outcome data from all operating room IUC insertions from June 2011 through December 2016 at the Northwestern University Feinberg School of Medicine were analyzed using a multivariable model to evaluate associations between CAUTI and inserting provider. Infection data before and after implementation of a simulation-based IUC competency course for medical students were compared. Results: A total of 57, 328 IUC insertions were recorded during the study period. Medical students inserted 12.6% (7, 239) of IUCs. Medical students had the lowest overall rate of CAUTI among all providers during the study period (medical students: 0.05%, resident/fellows: 0.2%, attending physicians: 0.3%, advanced practice clinicians: 0.1%, nurses: 0.2%; P = .003). Further, medical student IUC placement was not associated with increased odds of CAUTI in multivariable analysis (odds ratio, 0.411; 95% confidence interval: 0.122, 1.382; P = .15). Implementation of a simulation-based curriculum for IUC insertion resulted in complete elimination of CAUTI in patients catheterized by medical students (0 in 3, 471). Conclusions: IUC insertion can be safely performed by medical students in the operating room. Simulation-based skills curricula for medical students can be effectively implemented and achieve clinically relevant improvements in patient outcomes. Abstract : Supplemental Digital Content is available in the text.