Authors: (including presenting author): :
Chan YH(1), Hong YF(1), Wong NY(1), Tsui YW(1), Wong TW(1), Sze CW(1), Leung SL(1), Tai CE(1), Tong YH(1), Tsoi LK(1), Wong TT(1), Hau KC(1), Ho YY(1), Tang PF(2), Cheng KL(2), Lam KM(2), Hau LM(1)(2)
Affiliation: :
(1)Department of Medicine and Geriatrics, Tuen Mun Hospital
(2)Department of Quality and Safety, New Territories West Cluster
Keyword 1: :
chest drain insertion
Keyword 2: :
simulation training
Keyword 3: :
bedside procedure safety
Introduction: :
Several complications and adverse incidents related to bedside chest drain insertion have occurred in recent years, leading to significant iatrogenic morbidity and mortality. The Rocket Seldinger chest drain kit was introduced in NTWC in 2024. A standardized, locally adapted training program was urgently needed and developed.
Objectives: :
1. Provide hands-on experience in bedside chest drain insertion with reference to simulation model. 2. Refresh knowledge and familiarize general medical colleagues with newer chest drain systems.
3. Promote a culture of clinical safety and reduce procedure-related complications.
Methodology: :
With support from the Department of Medicine and Geriatrics (M&G), the Clinical Skills Training Centre, and NTWC Q&S, we designed a chest drain workshop primarily targeting newly joined residents. An animal rib model was used as a surrogate to practice insertion, offering realistic tactile feedback on drain position and cost-effectiveness. A departmental guideline for bedside chest drain insertion was developed and circulated as pre-course reading. The inaugural workshop was conducted on 10 July 2025. Participation was mandatory for newly joined M&G colleagues as part of orientation; other staff could enroll subject to availability. The workshop comprised a pre-test, a brief lecture, hands-on practice with various drain models available in M&G, and a post-test. The lecture covered background, troubleshooting, human factors, and psychological safety in relation to previous incidents. Respiratory team tutors facilitated small groups hands-on skills session, providing real-time feedback and discussion. After the course, first-year colleagues are required to have their first six bedside chest drain insertions directly observed by senior departmental staff as part of a credentialing process. To our knowledge, this is the first trial of such credentialing in Hong Kong.
Result & Outcome: :
A total of 41 doctors, including all 13 newly joined doctors from the past year, attended the workshop. Median self-reported confidence increased from 3/10 pre-course to 7/10 post-course. All participants (100%) agreed or strongly agreed that the course met its objectives and were satisfied with the organization. Given the positive impact, an annual workshop is planned. A cross-specialty workgroup is also being contemplated to align training with the needs of various NTWC departments.
