266 - The Success of Resident-Performed Lumbar Punctures at a Large, Single-Center Children’s Hospital

Poster Number: 266
Publication Number: 266.330

James Rudloff, Washington University in St. Louis School of Medicine, St. Louis, MO, United States; Liz Lendrum, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Matthew J. Lipshaw, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Caitlin Valentino, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Lumbar puncture (LP) rates have declined across U.S. children’s hospitals over the past decade, potentially decreasing procedural learning opportunities for pediatric resident trainees required by the ACGME.

Objective: We sought to determine whether success rates of LPs performed by pediatric residents have significantly changed over time.

Design/Methods: This study is a single-center retrospective study to evaluate pediatric resident LP success. We evaluated our primary outcome, rate of overall LP success over time, using Poisson linear regression. We similarly used linear regression for success rates of resident-associated lumbar punctures over time. We calculated the median number of lumbar punctures of all pediatric residents during the time period.

Results: 3,143 LPs were observed over an eight-year period. Both the overall rates of lumbar punctures and the success rates of lumbar punctures have not significantly changed over an eight-year period. Similarly, resident-associated LPs rates and success rates have not changed over the study period. Pediatric residents performed a median of three LPs in the PED over residency.Conclusion(s): Despite national trends showing decreased LP rates at pediatric hospitals, we demonstrated stable LP rates and success rates among pediatric residents. Pediatric residents perform a relatively low number of LPs in the PED setting alone. Future research is needed to demonstrate whether these overall low numbers translate to procedural competency after residency graduation.
Table 1. Rates of Lumbar Punctures Per 1,000 Patient Encounters
Table 2. Success Rates of Lumbar Punctures