I learned to drive on my brother’s 1942 Ford and my first car was a twelve year old 1948 Pontiac. Since that time, I have owned and rented many cars that were made by various manufacturers; General Motors, Chrysler, Ford, Honda, Fiat and Renault. Despite being made by different manufacturers in different countries, they all had one thing on common; I could drive them all without having to first read a manual or get special “in service” instructions. This was possible because the important controls for all cars are the same. The brakes, accelerators, steering wheels were all in the same location. Although there are minor variations in the location of headlight, directional signals and windshield wiper controls, it seldom takes more than a minute to find them. Modern cars may now have unique features like backup cameras, navigation systems, Bluetooth phone connections and many others, but the fundamental controls that are necessary to operate the vehicle safely all remain the same. This not only makes it easier for us to drive each car, but because of our familiarity with the important controls, we are able to react instinctively in hazardous situations and, in general, drive more safely.
If it is possible for automobiles with all of their features to all share similar controls regardless of their manufacturer or country of origin, it should also be possible to have this for medical devices. Infusion pumps for example all share similar characteristics. Users must turn them off and on; they must have a method of setting flow rates and the amount to be infused. They all have alarms for proximal and distal occlusions, dosage completion, and low batteries. While different model pumps may have unique features that take extra time to learn, like automobiles, they all share certain common controls. Bedside monitors all share similar characteristics. They all must be turned off and on and they have high and low alarm settings for the various monitoring parameters. Almost all devices like O2 sat monitors, ventilators, infant incubators, defibrillators, and EKG machines share certain fundamental characteristics.
When hospitals buy new devices to update to new technologies or merely replace those that are no longer serviceable nurses and other caregivers must undergo re-training to learn how to use the basic controls and other features. This training process is costly and until all users are completely familiar and comfortable with the location and operation of all of the controls and alarms, the opportunities for error and patient harm are increased. If, as with automobiles, the common basic controls of all devices were located and operated similarly, training costs and opportunities for patient harm would be reduced. When nurses encountered a new monitor or infusion pump, regardless of model or manufacturer they would immediately be able to turn it on and set the critical controls without needing special training. Obviously, they would have to learn how to use any unique features but they would at least know how to operate the critical controls and alarm settings. As they gained years of experience using the same controls, they would be able to respond instinctively to problems. This would significantly reduce the possibility of use errors, increase patient safety and perhaps save lives.
