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Table 1 Temporary dialysis catheter insertion checklist: percentage of participants who performed each checklist item correctly

From: Use of a national continuing medical education meeting to provide simulation-based training in temporary hemodialysis catheter insertion skills: a pre-test post-test study

ITEM Pretest (%) n = 22 Posttest (%) n = 17
Informed consent obtained 77.3 88.2
 Benefits (must state 1)
 Risks (must state 2)
 Consent given
Washes hands 36.4 88.2
Places the patient in slight Trendelenburg position 22.7 88.2
Tests each port and flushes the lines with sterile saline 63.6 100
Clamps each port (may leave distal port open) 68.2 100
Area cleaned with chlorhexidine in a back and forth motion for at least 30 seconds 4.5 100
Gets in sterile gown, gloves, mask and cap 81.8 100
Area draped in usual fashion using full body drape 50.0 100
Ultrasound probe is properly set up, draped, and sonographic gel is used 59.1 88.2
The vein is localized using anatomical landmarks with the ultrasound machine 86.4 100
The skin is anesthetized with 1% lidocaine in a small wheal 81.8 100
The deeper structures are anesthetized 77.3 94.1
Using the large needle- (or catheter-) syringe complex, the vein is cannulated while aspirating (must be done with ultrasound) 59.1 100
Syringe is removed from the needle and the needle is held steady 63.6 94.1
The guidewire is advanced into the vein no more than 10-20 cm 22.7 100
The skin is knicked where the guidewire enters the skin (using a scalpel) 68.2 88.2
The dilator is advanced over the guidewire and the vein is dilated. 72.7 100
The catheter is advanced over the guidewire (with the guidewire held steady while catheter is moved forward) 59.1 100
Never lets go of the guidewire 54.5 100.0
As soon as line is in place, the guidewire is removed in its entirety 68.2 100.0
The line was advanced 14-16 cm (any other measurement is wrong) 31.8 100.0
Ensures there is blood flow from each port and flushes each port with sterile saline 50.0 88.2
Line is secured in place 54.5 100.0
Locks both ports with heparin or citrate 40.9 94.1
Places dressing over line or verbalize this 45.5 88.2
Requests a chest x-ray to confirm location 54.5 94.1
Notifies or places order that line is ok to use 45.5 100.0
Maintained sterile technique throughout 50.0 100.0