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Geavanceerde medische technologie in de thuissituatie - Inventarisatie, gebruikersaantallen en risico's
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Series / Report no.
RIVM rapport 265011004
Open Access
Type
Report
Language
nl
Date
2006-02-08
Research Projects
Organizational Units
Journal Issue
Title
Geavanceerde medische technologie in de thuissituatie - Inventarisatie, gebruikersaantallen en risico's
Translated Title
Overview, frequency of use and risks of advanced medical technologies in home care
Published in
Abstract
De patientveiligheid bij gebruik van geavanceerde medische technologie in de thuissituatie kan worden bevorderd door het nemen van adequate beheersmaatregelen op basis van kennis van de risico's. Een goede communicatie tussen alle partijen binnen de zorgketen is daarbij essentieel. Hoewel meestal met succes toegepast, is aandacht voor risico's van belang omdat medische apparatuur, zoals beademingsapparatuur en infuuspompen, in toenemende mate in de thuissituatie wordt ingezet. Risico's die samenhangen met de toepassing van deze apparatuur thuis ontstaan doordat de technologie ook wordt toegepast door minder geschoolde personen zoals patienten en mantelzorgers. Daarnaast hebben professionele zorgverleners niet altijd de gelegenheid om voldoende vaardigheid te ontwikkelen, worden technische en medische problemen minder snel ontdekt en zijn deze soms minder snel te verhelpen dan in het ziekenhuis. In het algemeen zijn de risico's het grootst voor technologieen die op populatieniveau bij veel patienten worden toegepast, die vitale functies overnemen, die invasief zijn of waarmee stoffen worden toegediend. Incidenten hangen vaak samen met gebruiksfouten, maar ook ontwerpfouten en technische mankementen komen voor. Zo zijn belangrijke beheersmaatregelen met betrekking tot productveiligheid: de ontwikkeling van apparatuur geschikt voor thuisgebruik, aanpassing van gebruiksaanwijzingen en het aanbrengen van goede alarmfuncties. Organisatorische beheersmaatregelen betreffen beperking van het assortiment apparaten waarmee zorgverleners moeten werken, de inzet van gespecialiseerde verpleegkundigen en aandacht voor begeleiding van patienten en mantelzorgers. Ook is een duidelijke afbakening van taken en verantwoordelijkheden van de betrokken partijen noodzakelijk. Implementatie van beheersmaatregelen is belangrijk, temeer daar de gebruikersaantallen de komende jaren nog zullen stijgen.
Advanced medical technologies, like respiratory and intravenous therapy devices, are finding increasing use in the home and this trend will continue in the near future. Home use of these complex medical devices implies several risks. Acknowledgement of the risks by all the parties involved - industry, government agencies, health practitioners and insurance companies - and adequate communication between all parties in the chain of care, as well as the implementation of proper preventive measures, will enhance patient safety. In general, risks are higher when a technology is invasive, used for life support or for the application of substances, and when it is applied to a large number of patients. Risks are often related to use errors and arise because at home poorly qualified persons, such as patients or informal carers, are using the device as well. Even home care professionals do not always have the opportunity to develop sufficient skills. Failures in design and technical problems also occur. Defects or medical problems may not be identified immediately and cannot always be solved as promptly as in the intramural setting. Important precautions that can be taken are the further development of devices designed for home use and adaptation of user manuals. Organizational precautions are the placing of limitations on the assortment of devices that professionals use, employment of specialized nursing teams, instruction and supervision of patient and informal carers, and finally, a clear demarcation of the tasks and responsibilities of all parties.
Advanced medical technologies, like respiratory and intravenous therapy devices, are finding increasing use in the home and this trend will continue in the near future. Home use of these complex medical devices implies several risks. Acknowledgement of the risks by all the parties involved - industry, government agencies, health practitioners and insurance companies - and adequate communication between all parties in the chain of care, as well as the implementation of proper preventive measures, will enhance patient safety. In general, risks are higher when a technology is invasive, used for life support or for the application of substances, and when it is applied to a large number of patients. Risks are often related to use errors and arise because at home poorly qualified persons, such as patients or informal carers, are using the device as well. Even home care professionals do not always have the opportunity to develop sufficient skills. Failures in design and technical problems also occur. Defects or medical problems may not be identified immediately and cannot always be solved as promptly as in the intramural setting. Important precautions that can be taken are the further development of devices designed for home use and adaptation of user manuals. Organizational precautions are the placing of limitations on the assortment of devices that professionals use, employment of specialized nursing teams, instruction and supervision of patient and informal carers, and finally, a clear demarcation of the tasks and responsibilities of all parties.
Description
Publisher
Rijksinstituut voor Volksgezondheid en Milieu RIVM
Sponsors
IGZ