Task shifting of intravitreal injections from physicians to nurses: a qualitative study

Abstract

Background: Intravitreal injections of anti-vascular endothelial growth factor are a high-volume procedure and represent a considerable workload on ophthalmology departments. Several departments have tried to meet this increase by shifting the task to nurses. To maintain high quality patient care, we developed a training program for nurses certifying them to administer injections. This qualitative study aimed to evaluate if the nurses were confident and in control after participating in the training program, and if they were satisfied with the training and the new task. Methods: During 2014-2018, twelve registered nurses were trained in a tertiary hospital in Central Norway. All nurses were interviewed individually (n=7) or in a group (n=5). We analyzed the interviews using Graneheim and Lundmans qualitative content analysis. Results: Twelve sub-themes clustered in four main themes 1) responsibility and safety, 2) motivation and respect, 3) collaboration and 4) reflection and evaluation. The nurses felt confident and in control when administering injections, but experienced moments of insecurity. The new task gave the nurses a sense of achievement and they highlighted improvement of patient’s lives as positive. A greater level of responsibility gave the nurses pride in their profession. They had suggestions that could improve training efficiency but were overall satisfied with the training program.Conclusion: Our study showed that the nurses were satisfied with the training and that learning a new task led to higher self-esteem and gained respect. Suggestions to improve the training were identified, which should be considered before implemented at other departments.