Abstract: SA-PO011
Non-Tunneled Hemodialysis Catheter Placement Experience and Perception of Graduating US Adult Nephrology Fellows
Session Information
- Educational Research
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Shah, Hitesh H., Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
- Sheikh, Fatima, Northwell, New Hyde Park, New York, United States
- Jhaveri, Kenar D., Northwell Health Sys, Great Neck, New York, United States
Background
Nephrology fellows are required to acquire skills and demonstrate competency in the placement of non-tunneled hemodialysis catheter (NT-HDC) during fellowship. To gain a greater insight in the NT-HDC placement experience and perception of US adult nephrology fellows, we carried out a national survey.
Methods
An on-line survey was created and sent to US adult nephrology fellows in May 2018. Data was further analyzed for fellows graduating in 2018.
Results
254 fellows responded to our survey (31.4% response rate). 128 (50.4%) were graduating in 2018. Most NT-HDCs were placed in the hospital and 17.3% reported having a dedicated rotation for NT-HDC placement. 33.9% received simulation based training, 14.2% received bedside training, 20.5% received both simulation and bedside training, while 29.1% did not receive any formal training in NT-HDC placement. 45.3% did not receive any formal didactic session on NT-HDC placement during fellowship. Of the 128 graduating nephrology fellows (G-NFs), 27.3% had not placed any femoral NT-HDC during fellowship while 25.8% had placed ≤3 and 27.3% had placed >10. While 35.1% of G-NFs had placed >10 internal jugular NT-HDCs during fellowship, 21% had placed ≤3 and 23.4% had placed none. 14.8% of G-NFs had not placed any NT-HDC. 41.4% of G-NFs needed to place at least 5 NT-HDCs before independently performing this procedure during fellowship, while 11.7% required ≥10. While 64.8% of the G-NFs reported having received adequate training in NT-HDC placement, only 37.5% planned to place NT-HDCs after graduation. Majority (57%) of G-NFs felt that nephrologists should not place NT-HDC in clinical practice. Reasons cited for those who had inadequate or no training in NT-HDC placement included: lack of opportunities to place NT-HDCs (53.9%), lack of formal training (41.4%), lack of nephrology faculty interest (42.97%) and expertise (32.8%).
Conclusion
While majority reported adequate training in NT-HDC placement, a significant percentage of graduating fellows had not placed either a femoral or internal jugular NT-HDC or both during fellowship. Majority received simulation based training, however a significant percentage did not receive any didactic session or formal training in NT-HDC placement during fellowship. Fellowship programs should take measures to ensure that all fellows receive adequate training in NT-HDC placement.