{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:35:52Z","timestamp":1760661352102,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,6,4]],"date-time":"2007-06-04T00:00:00Z","timestamp":1180915200000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Central venous catheters placed in femoral veins increase the risk of complications. At our institution, residents place most catheters in the femoral vein.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Determine whether a hands\u2010on educational session reduced femoral venous catheterization and improved residents' confidence and adherence to recommendations for infection control.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN<\/jats:title><jats:p>Firm\u2010based clinical trial between November 2004 and March 2005.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING<\/jats:title><jats:p>General medical wards of Cook County (Stroger) Hospital (Chicago, IL), a public teaching hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>PARTICIPANTS<\/jats:title><jats:p>Internal medicine residents (n = 150).<\/jats:p><\/jats:sec><jats:sec><jats:title>INTERVENTION<\/jats:title><jats:p>Before their 4\u2010week rotation, intervention\u2010firm residents received a lecture and practiced placing catheters in mannequins; control\u2010firm residents received the usual training.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS<\/jats:title><jats:p>Venous insertion site, adherence to recommendations for infection control, knowledge and confidence about catheter insertion, and catheter\u2010associated complications<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Residents inserted 54 catheters, or 0.24 insertions per resident per 4\u2010week rotation. There was a nonsignificant decrease in femoral insertions for nondialysis catheters in the intervention group compared to the control group (44% vs. 58%), difference: \u221214% (95% CI, \u221252% to 24%). The intervention significantly increased residents' knowledge of complications related to femoral vein catheterization and temporarily increased their confidence about placing internal jugular or subclavian venous catheters. Intervention\u2010group residents were more likely to use masks during catheterization (risk ratio, 2.2; 95% CI, 1.3\u20102.7), but other practices were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Our intervention improved residents' knowledge of complications and use of masks during catheter insertion; however, it did not significantly change venous insertion sites. Catheter insertions on our general medicine wards are infrequent, and the skills acquired during the skills\u2010building session may have deteriorated given the few clinical opportunities for reinforcement. 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