Abstract: SA-PO187
Dialysis Catheter Placement Experience of US Adult Nephrology Fellows: A National Survey
Session Information
- Educational Research
October 27, 2018 | Location: Exhibit Hall, San Diego 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, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
- Jhaveri, Kenar D., Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
Background
Nephrology fellows in the United States (US) are required to acquire skills and demonstrate competency in the placement of temporary/non-tunneled hemodialysis catheter (NT-HDC) during fellowship. To gain a greater insight in the dialysis catheter placement experience of US adult nephrology fellows, we carried out a national survey of nephrology fellows.
Methods
An anonymous on-line survey was created and sent to US adult nephrology fellows via fellowship program coordinators in May 2018.
Results
So far, 113 fellows have responded to our survey. 48% were graduating in 2018. Most NT-HDCs were placed in the hospital. While 26% had not placed any femoral NT-HDC during fellowship, 28% had placed >10. 36% had placed >10 internal jugular NT-HDC during fellowship, while 28% had placed none. 34% received simulation based training, 12% received bedside training, 23% received both simulation and bedside training, while 31% did not receive any formal training in NT-HDC placement. 53% had most of their NT-HDC placements supervised by a nephrology attending. However, 49% had no nephrology attending placing NT-HDC in their institutions. 43% needed to place at least 5 NT-HDCs before independently performing this procedure during fellowship, while 16% required ≥10. While 70% reported having received adequate training in NT-HDC placement during their fellowship, only 32% planned to place NT-HDC after graduation. While 67% felt that fellowship programs should be required to train fellows in NT-HDC placement, majority (57%) felt that nephrologist should not place NT-HDC in clinical practice. Reasons cited for those who had inadequate or no training in NT-HDC included: lack of formal training (23%), lack of opportunities to place NT-HDC (23%), lack of nephrology faculty interest (20%) and lack of faculty expertise (16%). 16% had placed at least 1 tunneled HD catheter and only 1 fellow had placed 1 PD catheter during fellowship.
Conclusion
While majority of fellows report adequate training in NT-HDC placement, a significant percentage of fellow had not placed a femoral or internal jugular NT-HDC during fellowship. Majority received simulation based training, however a significant percentage did not receive any 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.