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.
To explore nurses' experiences regarding the education followed in the use of AMTs in the home setting, and their organizations' systems of reporting.
Developments in and the increased use of advanced medical technologies (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 achieved through educational interventions tailored to the device, education about the risks and how to deal with them (Fex et al., 2012; Porte et al., 2018). For the purpose of this study, we use the definition of AMTs as ‘devices that are life-supporting or life-sustaining in their application, or their use is of substantial importance in preventing impairment of human health, or their use prevents a potential unreasonable risk of illness or injury’ (APSF, 2016).
Several studies have shown that educational interventions in learning how to use medical devices properly and safely are both essential and effective (Keller et al., 2017; Shukla and Muthal, 2017). Although educational interventions are effective, at least in the short-term, continual systematic training, periodical intervention reinforcement and assessment are necessary after formal education has been completed (Ewertsson et al., 2015; Forsberg and Engström, 2018). Medical devices are continually developing and therefore an approach of lifelong learning is essential among professionals who use such technologies (Keller, 2010). In nursing, learning also relates to active reflection about existing situations and concrete actions have to be taken to generalize knowledge and skills. Experiential learning, according to Kolb's learning cycle, applies to a process of having a concrete experience grounded in practice, reflective observation about the experience, learning from the experience through abstract conceptualisation and active experimentation of what has been learned (Kolb, 1984).
From the 1990s, frequently identified methods of learning how to use a medical device were trial and error (self taught), learning by watching a video or slide tapes, training on-the-job or receiving instruction from another staff nurse (McConnell and Hilbig, 2000). Other forms of learning used over time include instructions by manufacturers, user manuals, and simulations (Fu et al., 2012; Gaba, 2004). New technologies to improve and extend learning in healthcare include web-based instruction, apps and social media (Bullock and Webb, 2015). An emerging educational technology in training in the use of medical devices is that of virtual reality simulation (Lino et al., 2016). The benefits of virtual simulation are, for example, that it offers a cost-effective approach to providing students with sufficient preparatory information to improve their knowledge and skills, and allowing practice in dealing with incidents in a safe environment, including allowing the trainee to make mistakes (Foronda et al., 2017; Kay et al., 2018).