EXPLORING MEDICAL DEVICES: THE USE OF RISK ASSESSMENT TOOLS AND THEIR LINK WITH TRAINING IN HOSPITALS

Dynamic risk assessment of hospital oxygen supply system by HAZOP and intuitionistic fuzzy

Events such as oxygen leakage in the oxygen generation systems can have severe consequences, such as fire and explosion. In addition, the disruption in the oxygenation systems can lead to a threat to patients' lives. Thus, this study aimed to identify the significant deviations in the oxygen supply system as critical equipment at hospitals based on the Hazard and Operability (HAZOP) method. Despite the advantages of risk assessment techniques, hazard identification techniques are still being utilized with deterministic and unreliable values and have a completely static nature. Therefore, using dynamic techniques to overcome intrinsic ambiguity in the risk assessment process through fuzzy sets has been recommended. Additionally, we proposed the HAZOP methodology to integrate with the intuitionistic fuzzy system for assessing the medical oxygen supply system using Pressure Swing Absorbance technology as a proactive approach. The results showed that the intuitionistic fuzzy approach, combined with the risk assessment method, is a suitable tool to eliminate uncertainty, improve decision-making, and result in more detailed and accurate findings. The approach adopted in this study can be used as a needs assessment tool to optimize maintenance programs and provide the necessary training for the staff, maintenance operators, and medical equipment managers.

Education and training of nurses in the use of advanced medical technologies in home care related to patient safety: A cross-sectional survey

BACKGROUND

To 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.

OBJECTIVES

To explore nurses' experiences regarding the education followed in the use of AMTs in the home setting, and their organizations' systems of reporting.

DESIGN

Descriptive cross-sectional design.

METHODS

209 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.

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 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.

CONCLUSIONS

This 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.

Impact of Design on Medical Device Safety

The growing number of emerging medical technologies and sophistication of modern medical devices (MDs) that improve both survival and quality of life indexes are often challenged by alarming cases of vigilance data cover-up and lack of sufficient pre- and post-authorization controls. Combining Quality with Risk Management processes and implementing them as early as possible in the design of MDs has proven to be an effective strategy to minimize residual risk. This article aims to discuss how the design of MDs interacts with their safety profile and how this dipole of intended performance and safety may be supported by Human Factors Engineering (HFE) throughout the Total Product Life-Cycle (TPLC) of an MD in order to capitalize on medical technologies without exposing users and patients to unnecessary risks.

Improving the uptake of medical device training to promote patient safety

Safe and effective patient care is dependent on the appropriate use of medical devices, so it is necessary to ensure that all nursing staff are competent in their use. This article describes how one urology ward in a large acute NHS trust has supported medical device training for its staff.

AIM

To explore the potential benefits of introducing a ward time out training day to improve staff competency in the use of medical devices.

METHOD

A training programme was introduced for the urology ward staff, which involved ward time out training days that covered medical device and mandatory training, alongside evidence to support nurses' revalidation and a forum for peer support.

FINDINGS

Since the ward time out training days were introduced in 2015, medical device training competency among the urology ward staff has risen from 65% to 97% across all staff groups, including nurses and healthcare assistants.

CONCLUSION

The ward time out training days were beneficial for the urology ward staff, and increased their medical device training competency. Additional benefits of the ward time out training days included team integration, improved knowledge and competency among staff, and nurses undertaking continuing professional development hours that contributed towards their revalidation.

Design and evaluation of a prototype of augmented reality applied to medical devices

BACKGROUND

According to current legislation, medical devices have to incorporate all the necessary information to eliminate or greatly minimise any problem associated with their use. However, the physical capacity of the actual device's packaging may frequently not be enough to contain all this information. To address this limitation, this study aimed to design and evaluate a prototype app for mobile devices applying augmented reality technology. The main feature of this kind of technology is combining virtual images with images from the real world.

METHODS

This work, carried out in Spain, was developed in three different phases. 1) Assessment of users' needs: Through a focus group and an online questionnaire, information was obtained about the following aspects: type of medical devices likely to be included in the app, relevant information that should be included and format in which this information should be presented. 2) Development of the prototype: Considering all the functional features identified in the previous phase, the software was developed by a team of professionals specialised in AR technology and applying a user-centred model. 3) Evaluation of the software: functionality and usability were assessed by means of the think-aloud method.

RESULTS

1) Assessment of users' needs: a total of 11 nurses participated in the focus group and 280 healthcare professionals answered the questionnaire. Their findings showed that users consider that information about the following aspects of medical devices should be included in the app: instructions for use, indications for use, brief description of the device, special precautions and biocompatibility, image of the content with its components and meaning of icons. 2) Description of the prototype: Once the app has been launched, when the user scans the medical device with the mobile device camera, access to the home screen is activated, where three sections can be found: name of the medical device, image of the device and four icons which provide access to: a brief description of the device, a detailed description of it, the packaging iconography and a video about use of the device. 3) Evaluation of the software: the app was defined by users as "very intuitive". They highlighted, as one of its main positive aspects, the chance to obtain information about the medical device just by scanning the object. Additionally, the evaluation performed through the think-aloud method identified potential improvements in the app. These improvements were subsequently implemented to make the prototype more functional.

CONCLUSION

Working with potential prototype users made it possible to identify information considered relevant for these users and to delve into the format which they consider more appropriate to show this information in the prototype. Our results show that AR technology can be used as support for clinical practice.