Geavanceerde medische technologie in de thuissituatie ...

RIVM rapport 265011004 pag. 5 van 132
Abstract
Overview, frequency of use and risks of advanced medical technologies in home care
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.
Keywords: home care, medical technology, frequency of use, risk, patient safety, use error