# Quality and Safety Management of Advanced Medical Technologies in Homecare in The Netherlands: A Qualitative Study on Consensus Development Regarding Approaches and Continuing Professional Education

## TL;DR

This study explores how homecare nurses in the Netherlands manage safety and quality when using advanced medical technologies at home, and what training they need.

## Contribution

The study identifies consensus among nurses on safety management approaches and highlights the need for ongoing education in advanced medical technology use.

## Key findings

- Distinguishing high-risk and low-risk incidents improves safety management efficiency.
- Team discussions increase incident reporting likelihood.
- Nurses advocate for mandatory assessments and individual responsibility for skill maintenance.

## Abstract

Background/Objectives: Dutch legislation sets requirements for the safe reporting of and learning from incidents. It also specifies the required competence of nurses in using medical technology. However, not all certified homecare nurses are adequately trained in patient safety. Patient safety management is reflected at different levels within homecare organisations. This study aimed to report on initial consensus among homecare nurses on responsibilities in quality and safety management at organisational, team and individual levels. It also explored nurses’ educational needs related to the use of advanced medical technologies (AMTs) in homecare. Methods: An exploratory qualitative study using consensus-oriented member checking was conducted. Building on research into incidents and safety management practices of AMTs, two semi-structured group interviews were conducted online with 11 homecare nurses from across the Netherlands. In a second round, feedback and comments were solicited on the resulting conclusions and statements in writing. Results: Distinguishing between high-risk and low-risk incident reports enhances the efficiency and effectiveness of safety management for AMTs in homecare. Team-based discussions increase the likelihood of incident reporting. Nurses advocate for periodic, mandatory assessments for technical homecare teams, conducted by an external body. They also emphasise individual responsibility for maintaining up-to-date knowledge and skills and taking action accordingly. Conclusions: In this study, key statements on which Dutch technical homecare nurses reached consensus are presented. The results underscore the importance of a safe organisational and team culture for incident reporting, as well as the need for an effective and efficient incident management system at a team level. An effective learning organisation contributes to enhancing patient safety.