Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses
Objectives We aimed to evaluate the effect of projection mapping (PM) on the quality and safety of central venous catheter (CVC) insertion under real-time ultrasound guidance.Design Prospective, observational, simulation study.Setting This study was conducted at the Yokohama City University Medical...
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| Format: | Article |
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e095803.full |
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| author | Hitoshi Sato Takahisa Goto Kazue Nakajima Kyota Nakamura Takeru Abe Keiko Tsuchiya Atsushi Miyazaki Arisa Fujii Daisuke Kuwabara Kazuhiro Minoguchi Hiromasa Kawakami |
| author_facet | Hitoshi Sato Takahisa Goto Kazue Nakajima Kyota Nakamura Takeru Abe Keiko Tsuchiya Atsushi Miyazaki Arisa Fujii Daisuke Kuwabara Kazuhiro Minoguchi Hiromasa Kawakami |
| author_sort | Hitoshi Sato |
| collection | DOAJ |
| description | Objectives We aimed to evaluate the effect of projection mapping (PM) on the quality and safety of central venous catheter (CVC) insertion under real-time ultrasound guidance.Design Prospective, observational, simulation study.Setting This study was conducted at the Yokohama City University Medical Center (Yokohama, Japan). Volunteer residents were enrolled over 12 months from January to December 2023.Participants and methods 12 rotating residents (postgraduation year (PGY) 1 and 2) and eight anaesthesia residents (PGY 3–5) placed the CVC in the internal jugular vein in a simulator under the real-time ultrasound guidance using the short-axis out-of-plane approach. The ultrasound image was provided either just caudad to the puncture site using the PM method or on the monitor of the ultrasound machine (conventional method) placed next to the simulator’s right shoulder. Each resident performed four punctures alternating between the PM and conventional methods, and the first method for each resident was chosen randomly. Eye-tracking analysis was also used to evaluate differences in gaze behaviour.Primary and secondary outcome measures The primary outcome was the procedure time defined as the time from the application of the ultrasound probe on the puncture field until successful puncture of the vein. The secondary outcomes were incidence of complications and eye-tracking analysis data.Results The time to complete the line placement was significantly shorter for the PM than for the conventional method (median (IQR) 22.5 (15.5–30.6) s vs 30.0 (20.4–95.4) s; p=0.02, Wilcoxon’s signed-rank test). The incidence of posterior vessel wall puncture was significantly lower in the PM method (0% vs 25%; p=0.02, McNemar’s test). Eye-tracking analysis revealed that the percentage of time spent gazing at the ultrasound image was higher in the PM than in the conventional method (61.6% (55.0–69.2) vs 45.7% (34.1–54.5); p<0.01).Conclusions The PM method facilitates ultrasound-guided CVC placement while preventing excessive needle advancement in the inexperienced operators. This was accompanied by enhanced fixation of the participants’ line-of-sight on the ultrasound image. |
| format | Article |
| id | doaj-art-a9074a37091f4af29ae75e2d2884e793 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-a9074a37091f4af29ae75e2d2884e7932025-08-20T03:48:18ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-095803Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glassesHitoshi Sato0Takahisa Goto1Kazue Nakajima2Kyota Nakamura3Takeru Abe4Keiko Tsuchiya5Atsushi Miyazaki6Arisa Fujii7Daisuke Kuwabara8Kazuhiro Minoguchi9Hiromasa Kawakami10Department of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanAnaesthesiology and Critical Care Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, JapanDepartment of Clinical Quality Management, Osaka University School of Medicine Graduate School of Medicine, Suita, Osaka, JapanDepartment of Quality and Safety management, Yokohama City University Medical Center, Yokohama, Kanagawa, JapanMedical Statistics, Fukushima Medical University, Fukushima, JapanYokohama City University, Yokohama, JapanDepartment of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanDepartment of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanDepartment of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanDepartment of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanDepartment of Anaesthesiology, Yokohama City University Medical Center, Yokohama, JapanObjectives We aimed to evaluate the effect of projection mapping (PM) on the quality and safety of central venous catheter (CVC) insertion under real-time ultrasound guidance.Design Prospective, observational, simulation study.Setting This study was conducted at the Yokohama City University Medical Center (Yokohama, Japan). Volunteer residents were enrolled over 12 months from January to December 2023.Participants and methods 12 rotating residents (postgraduation year (PGY) 1 and 2) and eight anaesthesia residents (PGY 3–5) placed the CVC in the internal jugular vein in a simulator under the real-time ultrasound guidance using the short-axis out-of-plane approach. The ultrasound image was provided either just caudad to the puncture site using the PM method or on the monitor of the ultrasound machine (conventional method) placed next to the simulator’s right shoulder. Each resident performed four punctures alternating between the PM and conventional methods, and the first method for each resident was chosen randomly. Eye-tracking analysis was also used to evaluate differences in gaze behaviour.Primary and secondary outcome measures The primary outcome was the procedure time defined as the time from the application of the ultrasound probe on the puncture field until successful puncture of the vein. The secondary outcomes were incidence of complications and eye-tracking analysis data.Results The time to complete the line placement was significantly shorter for the PM than for the conventional method (median (IQR) 22.5 (15.5–30.6) s vs 30.0 (20.4–95.4) s; p=0.02, Wilcoxon’s signed-rank test). The incidence of posterior vessel wall puncture was significantly lower in the PM method (0% vs 25%; p=0.02, McNemar’s test). Eye-tracking analysis revealed that the percentage of time spent gazing at the ultrasound image was higher in the PM than in the conventional method (61.6% (55.0–69.2) vs 45.7% (34.1–54.5); p<0.01).Conclusions The PM method facilitates ultrasound-guided CVC placement while preventing excessive needle advancement in the inexperienced operators. This was accompanied by enhanced fixation of the participants’ line-of-sight on the ultrasound image.https://bmjopen.bmj.com/content/15/5/e095803.full |
| spellingShingle | Hitoshi Sato Takahisa Goto Kazue Nakajima Kyota Nakamura Takeru Abe Keiko Tsuchiya Atsushi Miyazaki Arisa Fujii Daisuke Kuwabara Kazuhiro Minoguchi Hiromasa Kawakami Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses BMJ Open |
| title | Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses |
| title_full | Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses |
| title_fullStr | Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses |
| title_full_unstemmed | Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses |
| title_short | Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses |
| title_sort | enhancing the quality and safety of central venous catheter insertion using projection mapping a prospective observational simulation study with eye tracking glasses |
| url | https://bmjopen.bmj.com/content/15/5/e095803.full |
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