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Table 2 Procedural checklist used by the video raters to evaluate performance

From: Prepackaged central line kits reduce procedural mistakes during central line insertion: a randomized controlled prospective trial

Action Correct Minor technical error Major technical error Breaches in aseptic technique
Preparation of materials (26 Points):     
Sterile gloves     
Sterile gown     
Disinfecting agent     
Sterile gauze     
Sterile compresses     
Local anesthetic     
3ml Syringe (for the anesthetic)     
Needle (for the anesthetic)     
Sterile drape     
Sterile fenestrated drape     
10 ml Syringe     
Distilled water (to simulate NaCl 0.9%)     
Seldinger needle     
Guide wire     
3-way ports     
Blood gas syringe     
TLC holder/ clip     
Suture thread     
Needle driver     
Adhesive bandage     
Sharps container     
Patient preparation (6 Points):     
Sterile use of ultrasound equipment, if applied to find the vein     
Hand washing/ sanitizing     
All of the following are worn: sterile gloves and gown, mask, cap     
Disinfection of the injection site     
Fenestrated drape is applied to injection site     
Injection of the local anesthetic (must aspirate before injection!)     
Central line insertion (19 Points):     
Both 10 mL syringes are filled with NaCl     
All 3 lumina of the catheter are flushed with NaCl     
All ports are blocked after the flush     
Repeat disinfection of the injection site (assistant)     
Insertion of Seldinger needle (30° angle)     
Patient is asked if he can still feel the needle     
The needle is inserted until the vein is punctured and blood can be drawn     
A sample for blood gas analysis is drawn     
Blood gas syringe is transferred to assistant     
Insertion of the guide wire     
Removal of the needle (the guide wire is secured in place)     
Skin incision along the guide wire     
Insertion of the dilator over the guide wire     
Insertion of the catheter over the guide wire     
The catheter is inserted through the skin only after the guide wire is secured     
Removal of the guide wire (the catheter is secured in place)     
Safe disposal of the guide wire (double knot/ sharps container)     
Blood is drawn from all 3 lumina     
All 3 lumina are flushed with NaCl     
Securing the catheter and clean-up (4 Points):     
TCL clip is attached to the catheter     
TLC clip is sutured in place     
The site of insertion is covered with an adhesive bandage     
All needles and the scalpel are safely disposed of (sharps container) and the work station is left clean     
Sum (max. 55 Points)     
Duration of the procedure  
Number of misunderstandings (Physician-Assistant)  
Number of questions from the assistants