Abstract
BackgroundTo use advanced medical technologies (AMTs) correctly and safely requires both specialist knowledge and skills, and an awareness of risks and how those can be minimized. Reporting safety concerns about AMTs in home care can contribute to an improved quality of care. The extent to which a health care organization has integrated the reporting, evaluation and learning from incidents is a key element of that organization's patient safety culture. ObjectivesTo explore nurses' experiences regarding the education followed in the use of AMTs in the home setting, and their organizations' systems of reporting. DesignDescriptive cross-sectional design. Methods209 home care nurses from across the Netherlands who worked with infusion therapy, parenteral nutrition and/or morphine pumps responded to the online questionnaire between July 2018 and February 2019. The analysis of the data was mainly descriptive. ResultsEducational interventions that are most often used to learn how to use AMTs were, as an average over the three AMTs, instruction by a nurse (71%), practical training in the required skills (71%) and acquiring information to increase theoretical knowledge (69%). Considerable attention is paid to patient safety (88%) and the home setting (89%). However, a substantial proportion of the nurses (up to 29%) use AMTs even though they had not been tested on their skills. 95% of the respondents were well acquainted with the incident reporting protocol of their organization, but only 49% received structural or regular feedback on any actions taken as a result of event reporting. ConclusionsThis study revealed aspects of nurses' education that imply risk factors for patient safety. Practical training is not always given, additional or retraining is often voluntary, and the required skills are not always tested. However, the results show that nurses do have a good awareness of patient safety. Incidents are mainly discussed within the team, but less at the organizational level.
Highlights
Developments in and the increased use of advanced medical tech nologies (AMTs) in the setting of the home have led to various and increasingly complex educational challenges within the nursing domain (McGrath and Higgins, 2006; Shin et al, 2006)
Both studies con cerned three advanced medical technologies (AMTs) that are often used in home care: infusion therapy, parenteral nutrition and morphine pumps
The present study explored the perspectives of the nurses in using the technologies in home care in terms of educational interventions and patient safety
Summary
Developments in and the increased use of advanced medical tech nologies (AMTs) in the setting of the home have led to various and increasingly complex educational challenges within the nursing domain (McGrath and Higgins, 2006; Shin et al, 2006). To use AMTs correctly and safely requires both specialist knowledge and skills, and an awareness of risks and how those can be minimized. This can be ach ieved through educational interventions tailored to the device, educa tion about the risks and how to deal with them (Fex et al, 2012; Porte et al, 2018). To use advanced medical technologies (AMTs) correctly and safely requires both specialist knowl edge and skills, and an awareness of risks and how those can be minimized. Results: Educational interventions that are most often used to learn how to use AMTs were, as an average over the three AMTs, instruction by a nurse (71%), practical training in the required skills (71%) and acquiring infor mation to increase theoretical knowledge (69%). Incidents are mainly discussed within the team, but less at the organizational level
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