SAFE USE OF MEDICAL DEVICES IN DUTCH HOSPITALS - Academic PhD Thesis

Sep 18, 2026

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Safe use of medical devices in Dutch hospitals is addressed through thesis research conducted at NIVEL (Netherlands Institute for Health Services Research) and VU University Medical Center Amsterdam. The work evaluates adverse medical device event incidence and explores risk assessment tools, training links, and factors affecting safe performance. Chapters also cover nurse proficiency testing for infusion pumps, specialist attitudes toward electrosurgery proficiency, and the need for stronger guidance when implementing safety guidelines. Support is acknowledged from the Dutch ministry of Health, Welfare and Sport.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages72

Reading Time3 h 1 min

AccessFree to download

Chapter 1 General introduction

Chapter 2 Adverse medical device events in Dutch hospitals

Chapter 3 Risk assessment tools and training

Chapter 4 Nurse proficiency for infusion pumps

Chapter 5 Attitudes toward proficiency for electrosurgery

Chapter 6 Implementing guidelines for safe device use

Chapter 7 General discussion

Safe Use of Medical Devices in Dutch Hospitals Petra Porte Safe use of medical devices in Dutch hospitals Petra Jacintha Porte Safe use of medical devices in Dutch hospitals The research presented in this thesis was conducted at NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands and the Department of Public and Occupational Health of the VU University Medical Center Amsterdam/Amsterdam Public Health research institute. NIVEL participates in the Netherlands School of Public Health and Care Research (CaRe), which is acknowledged by the Royal Netherlands Academy of Arts and Sciences (KNAW) . Financial support for the studies in this thesis was provided by the Dutch ministry of Health, Welfare and Sport. ISBN: 978-94-6122-573-3 Cover design: Anouk Voorn Layout: Anna Bleeker | [www.persoonlijkproefschrift. nl](www.persoonlijkproefschrift. nl) Print: [Ridderprint | www. ridderprint. nl](Ridderprint | www. ridderprint. nl) © 2019 P.J. Porte All rights are reserved. No part of this thesis may be reproduced, distributed or transmitted in any form or by any means without prior written permission of the author. VRIJE UNIVERSITEIT SAFE USE OF MEDICAL DEVICES IN DUTCH HOSPITALS ACADEMISCH PROEFSCHRIFT ter verkrijging van de graad Doctor aande Vrije Universiteit Amsterdam, op gezag van de rector magnificus prof.dr. V. Subramaniam, in het openbaar te verdedigen ten overstaan van de promotiecommissie van de Faculteit der Geneeskunde op woensdag 29 januari 2020 om 11.45 uur in de aula van de universiteit, De Boelelaan 1105 door Petra Jacintha Porte geboren te Voorschoten promotoren: copromotoren: prof.dr. C. Wagner prof.dr. C. P. M. van der Vleuten dr. L. M. Verweij [prof.dr. M.C. de](prof.dr. M.C. de) Bruijne TABLE OF CONTENTS Chapter 1 General introduction 8 Chapter 2 The incidence and nature of adverse medical device events in Dutch 20 hospitals, a retrospective patient record review study Chapter 3 Exploring medical devices: the use of risk assessment tools and their link 36 with training in hospitals Chapter 4 Improving the proficiency of nurses: Validation of a proficiency test for 50 infusion pumps Chapter 5 Proficient until proven unproficient? Exploring attitudes and perceptions 70 of medical specialists on proficiency, proficiency requirements and proficiency tests for the safe use of electrosurgery: a qualitative study Chapter 6 Hospitals need more guidance on implementing guidelines for the safe 86 use of medical devices Chapter 7 General discussion 106 Summary 120 Samenvatting 126 List of publications 134 Dankwoord 138 About the author 140 CHAPTER 1 General introduction Chapter 1 General introduction TO ERR IS HUMAN “The problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer”.1 The Harvard Medical Practice Study was the first study to estimate the number of adverse events (AEs) in hospitalised patients. It estimated that AEs occurred in 3.7% of hospitalisations, and that 27.6% of the AEs were due to negligence.2 The Institute Of Medicine aimed to improve the safety of patients by designing processes of care to ensure that patients are safe from AEs. This led to growing international awareness of the fact that the hospital is not naturally a safe place for patients. Despite the growing interest in patient safety and the increasing number of safety regulations around medical devices, little is known about their safe use. Several countries initiating research to improve patient safety often measure harm as a starting point. Even though a shift is going from safety-I thinking ensuring that ‘as few things as possible go wrong’ to safety-II thinking, ensuring that ‘as many things as possible go right’.3 Following the example of the Harvard Medical Practice Study, research groups from all over the world carried out similar studies in their ow

FAQs

What research sites supported the thesis on medical device safety?

The research was conducted at NIVEL in Utrecht and at the Department of Public and Occupational Health of VU University Medical Center Amsterdam/Amsterdam Public Health research institute.

How are adverse medical device events approached in the thesis?

The thesis examines the incidence and nature of adverse medical device events in Dutch hospitals using a retrospective patient record review study.

Which training and proficiency aspects are investigated for safer device use?

It studies how risk assessment tools link to training, validates a proficiency test for infusion pumps, and explores specialists’ attitudes and perceptions regarding proficiency requirements and tests for electrosurgery.

Sep 18, 2026

Upload by Gloria