Article Index

Summary

Clinical negligence is costing the NHS over £2m per year and will increase by 25% per year over the next 5 years ( Bourn 1997). The risks associated with the use of high tech devices, in the presence of poor training, are great. The medical devices agency received over 4,000 adverse incident reports in the year 1995-96, this figure has increased every year for the past 5 years ( MDA DB 9701, 1997).

Lack of training is identified as a significant cause of infusion device related adverse incidents. Training in many areas is either little or non existent and tends to be experiential and not competency based. The need to develop appropriate training strategies is needed if the 'bleeding vein' of clinical negligence payments is to be arrested.

This author believes that training should be facilitated, structured, coordinated and competency based otherwise it runs the risk of fragmentation and becoming ineffective. The appointment of a Medical Devices Officer is a cost effective way of addressing the issues highlighted in this paper as well as implementing local and national issues and should be explored in other similarly sized Trusts.

 

References

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Adverse Incidents Reports 1996, MDA DB 9701, Medical Devices Agency Publication, DOH, London.

Bastos PG; Knaus WA et al. (1996), The importance of technology for achieving superior outcomes from intensive care, Intensive Care Medicine, 22(7): 664-9.

Bourn J, (1997), Report by the comptroller general : NHS (England) summarised accounts 1995-96, National Audit Office Publication, HC 127.

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Doing No Harm, (1995), Medical Devices Agency Publication. DOH, London.

Infusion Systems MDA DB 9503 (1995), Medical Devices Agency Publication, DOH, London

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The Report Of The Expert Working Group On Alarms On Clinical Monitors, (1995), Medical Devices Agency Publication, In response to rec. 11 of the Clothier report : The Allitt Inquiry

The Management of Infusion Systems MDA DB 9504, (1995), Medical Devices Agency, DOH, London.

The Management of Medical Equipment and Devices, HEI 98 (1991, currently due for reprint summer 1997), Medical Devices Agency, DOH, London.

Zimmermann et al, (1993) Critical Care Medicine; 21:1443 -1451 quoted in Morgan CJ et al (1996), Definition and Detection of alarms in critical care. Comput Methods Programms Biomed, 51(1-2):5-11.

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