Learning how to use new healthcare technology is a complex challenge, and success hinges on high-level support at any organization, according to nurses, vendors, and other experts who attended the AAMI Foundation’s first Industry Council meeting.
This diverse group—which included representatives from BD (formerly CareFusion), Connexall, Hospira (a Pfizer company), Masimo, and Medtronic, as well as patient safety advocates and healthcare professionals—met yesterday at AAMI’s headquarters in Arlington, VA, to discuss the current state of training, identify challenges, and describe what they would like to see in the future.
“Devices have become more interconnected and complex,” said Mary Logan, president of AAMI and the AAMI Foundation. “However, the training models we are using are based on the past. If we started from scratch today, based on the current clinical environment, we would not be training nurses in the same way.”
Nursing is a very device-heavy discipline. According to Peter Doyle, instructional design program manager at Johns Hopkins Hospital in Baltimore, MD, there has been a 23% increase in device types at his institution over the past four years, and many of these devices have different makes, models, and software versions.
Learning everything about every device just isn’t feasible, according to the nursing representatives, who point to increasing demands on their time, which makes it very hard to even attend training sessions. Additionally, there is an entrenched cultural desire in nursing to focus on the patient, not technology. Finally, they noted, there are limits to how much any one person can learn and retain.
Breaking information into “small digestible bites” is a strategy Maria Cvach, a registered critical care nurse and director of policy management and integration at Johns Hopkins Hospital has used with success. In her experience, once people become comfortable with one concept you can then build on it, slowly adding to their repertoire.
Everyone around the table agreed that getting the C-suite to understand the importance of training was essential.
According to Connie Barden, a clinical nurse specialist and chief clinical officer of the American Association of Critical Care Nurses, anything that takes nurses away from the unit is considered “nonproductive time.” Therefore, chief financial officers and chief operating officers, as well as chief nursing officers, need to be in the room when these issues are being discussed.
Despite the importance of developing better educational models and C-suite buy-in, the challenges of working with healthcare technology can't be answered only with more training.
Nurses are already overloaded, and we are constantly “shoehorning so much more stuff into a finite amount of time,” according to Barden. She and other healthcare representatives in attendance called on industry to focus on usability and human factors to make devices more intuitive and easier to use.
“Keep it simple,” Barden said, “and don’t rely on education to make the device safe.”
Beyond the challenge of effective training is the question of assessing competencies. Currently, there is no uniform system or even philosophy to assess competencies in the use of healthcare technology. Several vendors pointed out that they can provide the training but would not be the ones to assess competency. Individual healthcare facilities, they said, must play a key role.
The AAMI Foundation will continue to investigate clinical preparation for nurses using complex healthcare technologies and is considering establishing a national coalition to address the issues raised during this meeting. Marilyn Neder Flack, senior vice president of patient safety initiatives and executive director of the AAMI Foundation, said that funding for such a coalition is crucial because the challenge is so complex that it will take a coordinated and sustained effort to bring about real change.