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Development and evaluation of an electronic medical device training passport to identify nurses' training needs

BACKGROUND

All nurses, particularly those working in critical care settings, are required to use medical devices when providing patient care. However, inconsistent practice and variations in documentation can make it challenging for nurses and nurse managers to identify what medical device training is required and when.

AIM

To develop and evaluate the use of an electronic medical device training passport to identify the training needs of nurses in intensive care units (ICUs).

METHOD

A pilot study was conducted in a multi-unit critical care department in London, England, to determine if the passport could make it easier to identify ICU nurses' medical device training needs compared with existing practice. Nine participants were first asked to identify their needs using existing spreadsheets or paper records, then asked to identify them using the passport. The participants were also interviewed to identify their training requirements before and after using the passport. The data were analysed quantitatively and qualitatively.

FINDINGS

The electronic passport significantly improved identification of medical device training needs compared with paperwork or spreadsheets for all device groups, except for medical devices used on high dependency units ( P ≤0.005). However, there may be issues related to nurses' behaviours and expectations, particularly that staff do not always recognise their need for training.

CONCLUSION

The findings of this pilot study suggest that the use of an electronic medical device training passport has many benefits and could make it easier to identify ICU nurses' training needs in clinical practice.

Multiparametric quality by design-fuzzy model applied in the development of a biomedical measuring system

This work presents the adaptation of the Quality by Design (QbD) approach for application in the quality assurance of a biomedical measuring system under development. First attempts in applying QbD to biomedical technologies indicated a significantly higher number of parameters than its traditional application in the pharmaceutical industry. These preliminary studies did not fulfill the QbD stage of Design Space (DS) configuration for biomedical devices, an essential step to identifying the proper operating ranges of parameters and guaranteeing quality features. Therefore, it persisted the challenge of configuring DS for health devices, overcoming dependences in the interaction of multiple process parameters and critical attributes. The present work develops a hybrid QbD-Fuzzy approach for multiparametric DS configuration. The proposed method was applied in the development phase of a low-cost and high-sensitive magnetic measuring system for locating metallic foreign bodies in patients, employing sensors based on the Giant Magnetoimpedance effect. The results provided the acceptable operating ranges of the multiple process parameters to ensure the biomedical equipment's suitability. The proposed strategy contributes to the QbD implementation in biomedical technologies and, therefore, promotes the reliability of diagnostic and therapeutic results in the clinical environment.

Improving the Competency of Nurses

To decrease infusion pump administration errors, time-consuming training is often initiated. The aims of this study were twofold: to develop minimum competency requirements for programming and operation of infusion pumps and to develop and validate a test for nurses based on those requirements. The test was completed by 226 nurses between May and December 2017. This study demonstrates that testing is a promising method to assess the competency of nurses in using medical devices. Moreover, test acceptability among nurses is high. Using competency requirements to develop a test offers the potential to tailor training needs and reduce training time.

An Ergonomic Testing System for the First Metatarsophalangeal Joint Stiffness

Osteoarthritis sufferers commonly have first metatarsophalangeal joint (MTPJ) problems in which articular surfaces are changed permanently due to fatigue. Therefore, medical devices for early diagnosis would increase the opportunity for prevention of disease progression. In previous studies on stiffness of the first MTPJ many details, although functionally of great importance, have not been fully considered including: design and size of the device, tribology consideration, and errors from device. Therefore, the motivation of our research was to enhance the device design by reducing the size of the device, and device design was enhanced by minimizing measurement errors through development of a new ergonomic left and right foot instrument located medial to the first MTPJ (instead of beneath the foot). The first MTPJ stiffness (N mm/kg radian) measurement was taken on 28 subjects with two replicates per subject by the same tester. The first MTPJ stiffness ranged from 3.49 to 14.42 N mm/kg radian with the mean (SD) value of 8.28 (3.15) N mm/kg radian for the left feet and 3.91 to 11.90 N mm/kg radian with the mean (SD) value of 7.65 (2.07) N mm/kg radian for the right feet. Reliability evaluation was measured using intraclass correlation coefficient and described an excellent reliability between two tests.