Medical Device Use Errors
Advances in medicine and technology have given the healthcare community several vital tools that improve patient care. However, a consequence of this progress is that healthcare has become an increasingly complex and device-heavy discipline. Without proper training and practice, slow-downs in care and errors can occur. As such, simulation-based learning should incorporate the use of real equipment.
Today, healthcare professionals are facing an explosion of increasingly diverse and complex devices that require specific knowledge to operate properly. Without training, these devices can be confusing to use, and, as a result, technology-induced errors in healthcare are on the rise. These errors negatively affect patient outcomes and sometimes cost lives.
A 2015 Harris Poll of 526 registered nurses showed that not understanding how to use medical equipment properly leads to costly errors. For example, the poll found that errors commonly occur when transcribing information from one machine to another. Transcription errors can cause the patient to receive the incorrect medication or the wrong dosage.
Moreover, healthcare providers work slower when they are unfamiliar with a device or piece of equipment. They might have to sacrifice time with patients as they learn how to use the equipment in real-time. Likewise, providers who are familiar with the equipment might have to take time away from their own patients to help coworkers use a device.
Despite their increasing complexity, healthcare technologies can ensure high-quality care and lower costs if used properly. A 2014 West Health Institute report estimated that a system of connected medical devices that seamlessly share health information with each other could improve safety and save $30 billion by reducing redundant testing, manual data entry, and transcription errors.
Therein lies the rub. Advanced medical devices and equipment will improve safety and the quality of care for patients, but some hospitals are too quick to implement cutting-edge technology without providing adequate training or analyzing how their staff will interact with the new devices. As a result, healthcare providers who do not know how to use the new technology will make costly mistakes.
Nonetheless, studies have shown that patient deaths and medical errors associated with healthcare equipment decline when protocols are created that assist in error reduction. Simulation-based training is already used by some hospitals to test and improve clinical skills and patient safety protocols.
Simulation sessions allow participants the opportunity to gain hands-on experience providing care. Therefore, healthcare simulation should incorporate the use of real equipment, so participants gain experience working with these devices.
Why Use Real Equipment During Simulation Sessions
A World Health Organization report on simulation in nursing and midwifery education supports the use of real equipment during simulation because “they enhance the realism of the scenario, allow for the acquisition of more accurate psychomotor skills, and improves students’ self-confidence for future clinical practice.”
Simulation sessions create opportunities for participants to apply what they have learned in the classroom and work hands-on to provide care. Learning is never passive during a simulation learning event as participants are forced to think critically, make decisions, and delegate tasks as they would during a real medical event.
It would follow, then, that participants should provide care using the same equipment they would use in the real world. Using real equipment in healthcare simulation provides realism and enhances relevancy for the learner.
If the scenario calls for the patient to be intubated, then the participants should use a real laryngoscope and tube to perform the procedure. Using these tools helps participants gain experience performing actions like positioning the patient’s head for proper visualization and accurate tube placement.
Through ongoing practice, participants gain more confidence in their ability to perform a procedure correctly in a real clinical environment. Likewise, using certain equipment becomes second-nature. This is important because a lack of adequate training on equipment lowers productivity and can lead to errors.
The Benefits of Using Real Equipment During Training
A roadblock to adequate device and equipment training comes from hospital executives who view this type of skill maintenance as “unproductive time” that takes away from patient care. However, productivity and patient safety both suffer when hospital staff are unfamiliar with or do not know how to use new equipment.
Lack of proficiency on equipment can cause a provider to perform an action incorrectly. For example, the provider may set an incorrect dose into an infusion pump they do not know how to use. Likewise, providers who do not know how to use a device have to ask others for help or training. This takes time away from patients and adds undue stress to staff who are already under tight schedules.
Conversely, hospital staff who have hands-on knowledge and use of equipment have greater mastery of the skills needed to provide safe, timely, and effective care. By allowing participants to think critically about their actions, specifically how they interact with the tools in the clinical environment, medical device misuse and errors can be reduced.
Hospital executives could use simulation to review existing safety protocols involving hospital equipment or even test, train, and implement new protocols. For example, when a patient is connected to multiple IVs, the lines can become tangled and cause them to drip at the wrong rate if they are not physically checked from source to destination.
Thus, a simulated scenario involving an IV can have the provider check the lines before they leave the room. Familiarity and repetition are keys to learning new skills, so adding this step to ongoing safety protocol practice will ingrain this process in the thinking of the staff and ensure this error is not repeated.
Moreover, as the equipment is updated or redesigned over time, a once familiar device can become difficult to use. Simulation sessions involving the device can help providers keep pace with evolving technology and become deft users.
Educators can assess each staff member’s level of competency with equipment during the sessions. Thus, they can determine when to end training and ensure that each staff member gets enough practice before they are sent to work with real patients.
Furthermore, a device can be too complex or not user-friendly enough to be useful to staff. Poor usability is a primary cause of errors, but practice through simulation can reveal inherent design flaws in the equipment. As staff work with the device, the session can reveal problems with the interface, for example, that make it too difficult to use competently.
Medical technology will continue to advance and improve healthcare. However, access to new equipment and devices alone will not prevent errors. Without training to teach healthcare providers how to use new technology properly, mistakes can be made as staff struggle to use equipment with which they are unfamiliar.
Therefore, healthcare professionals need to practice using the equipment before they provide care for patients. By using real equipment during simulation learning events, providers gain experience working with the equipment and using it as intended. The time spent training helps providers identify potential errors and change behaviors so they can deliver the best care possible.
 Martins, Jose Carlos Amado, et al. “Simulation in nursing and midwifery education.” World Health Organization, 2018, http://www.euro.who.int/__data/assets/pdf_file/0011/383807/snme-report-eng.pdf?ua=1. PDF.