by Mr Chris Quinn RGN, MBA, PgDMS, FETC, ENB 100, ENB 998
Medical Devices Officer, Royal Victoria Infirmary & Associated Hospitals NHS Trust
Newcastle Upon Tyne
Introduction
The development and impact of technology has never been more apparent than in today's health care environment. This is particularly evident in the nursing and midwifery professions. Sophisticated procedures, techniques and risk management requirements have led to the continued development of all types of devices.
There has been an emphasis shift whereby many device functions have moved from being one of supporting clinical practice to that of being an integral requirement in treatment delivery. The ability to reduce hospital mortality is associated with the amount of technology available (Bastos et al 1996). Clinicians are at a stage that without the use of the many available devices procedures could not be carried out safely. "Remarkable progress in improved outcomes from some conditions, particularly when severely ill patients, are treated in well equipped and well managed intensive care units (ICU) which have clear directorship and comprehensive management guidelines and protocols" (Zimmermann et al, 1993).
This however, is a double edged sword because as devices become more complex the associated risks also increase and as such also need to be managed. It is clear that improved training is an integral part of any good risk management strategy (Cooper 1994; Orser & Oxorn 1994). How many nurses or doctors can claim that they have had comprehensive competency based training on the devices they use, the author suspects not many. It is also increasingly evident that unless NHS Trusts start to address risk management issues significant financial penalties may be incurred through an ever increasing trend towards medical negligence claims ( Bourn 1997).
This article focuses on the steps taken by one Trust to minimise the risks associated with the use of intravenous infusion devices through the development and introduction of a quality training strategy.