Background: The number of medical technologies used in home settings has increased substantially over the last 10–15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on types, trends and experiences with the use of advanced medical technologies at home.Methods: The study focused on advanced medical technologies that are part of the technical nursing process and ‘hands on’ processes by nurses, excluding information technology such as domotica. The systematic review of literature was performed by searching the databases MEDLINE, Scopus and Cinahl. We included papers from 2000 to 2015 and selected articles containing empirical material.Results: The review identified 87 relevant articles, 62% was published in the period 2011–2015. Of the included studies, 45% considered devices for respiratory support, 39% devices for dialysis and 29% devices for oxygen therapy. Most research has been conducted on the topic ‘user experiences’ (36%), mainly regarding patients or informal caregivers.Results show that nurses have a key role in supporting patients and family caregivers in the process of homecare with advanced medical technologies and in providing information for, and as a member of multi-disciplinary teams. However, relatively low numbers of articles were found studying nurses perspective.Conclusions: Research on medical technologies used at home has increased considerably until 2015. Much is already known on topics, such as user experiences; safety, risks, incidents and complications; and design and technological development. We also identified a lack of research exploring the views of nurses with regard to medical technologies forhomecare, such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety
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This white paper is presented by the Ethics Working Group of the uNLock Consortium This white paper presents findings of the Ethics Working Group, from the conceptual phase of investigation into the ethical issues of the uNLock solution, providing identity management solutions for sharing and presentation of medical COVID-19 credentials (test results) in the context of healthcare institutions. We have provided an outline of direct and indirect stakeholders for the uNLock solution and mapped values, benefits, and harms to the respective stakeholders. The resulting conceptual framework has allowed us to lay down key norms and principles of Self Sovereign Identity (SSI) in the specific context of uNLock solution. We hope that adherence to these norms and principles could serve as a groundwork for anticipatory mitigation of moral risk and hazards stemming from the implementation of uNLock solution and similar solutions. Our findings suggest that even early stage of conceptual investigation in the framework of Value Sensitive Design (VSD), reveals numerous ethical issues. The proposed implementation of the uNLock app in the healthcare context did not proceed further than prototype stage, thus our investigation was limited to the conceptual stage, and did not involve the practical implementation of VSD method involving translation of norms and values into engineering requirements. Nevertheless, our findings suggest that the implementation of VSD method in this context is a promising approach that helps to identify moral conflicts and risks at a very early stage of technological development of SSI solutions. Furthermore, we would like to stress that in the light of our findings it became painfully obvious that hasty implementation of medical credentials system without thorough ethical assessment, risks creating more ethical issues rather than addressing existing ones.
Abstract Managing adverse drug reactions (ADRs) is a challenge, especially because most healthcare professionals are insufficiently trained for this task. Since context-based clinical pharmacovigilance training has proven effective, we assessed the feasibility and effect of a creating a team of Junior-Adverse Drug Event Managers (J-ADEMs). The J-ADEM team consisted of medical students (1st–6th year) tasked with managing and reporting ADRs in hospitalized patients. Feasibility was evaluated using questionnaires. Student competence in reporting ADRs was evaluated using a case-control design and questionnaires before and after J-ADEM program participation. From Augustus 2018 to Augustus 2019, 41 students participated in a J-ADEM team and screened 136 patients and submitted 65 ADRs reports to the Netherlands Pharmacovigilance Center Lareb. Almost all patients (n = 61) found it important that “their” ADR was reported, and all (n = 62) patients felt they were taken seriously by the J-ADEM team. Although attending physicians agreed that the ADRs should have been reported, they did not do so themselves mainly because of a “lack of knowledge and attitudes” (50%) and “excuses made by healthcare professionals” (49%). J-ADEM team students were significantly more competent than control students in managing ADRs and correctly applying all steps for diagnosing ADRs (control group 38.5% vs. intervention group 83.3%, p < 0.001). The J-ADEM team is a feasible approach for detecting and managing ADRs in hospital. Patients were satisfied with the care provided, physicians were supported in their ADR reporting obligations, and students acquired relevant basic and clinical pharmacovigilance skills and knowledge, making it a win-win-win intervention.
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