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

Abstract

Background Intravitreal injections of anti-vascular endothelial growth factor are high-volume procedures 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 that certifies them to administer injections. This qualitative study aimed to evaluate whether the nurses were confident and in control after participating in the training program and whether they were satisfied with the training and the new task. Methods Between 2014 and 2018, 12 registered nurses were trained in a tertiary hospital in central Norway. All the nurses were interviewed, either individually (n = 7) or in a group (n = 5). We analysed the interviews using Graneheim and Lundman’s qualitative content analysis. Results Eight subthemes were clustered within four main themes: 1) procedure and challenges, 2) motivation, 3) cooperation and confidence, and 4) 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 patients’ 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. Conclusions Our study showed that the nurses were satisfied with the training and that learning a new task led to higher self-esteem and increased respect from patients and colleagues. Suggestions to improve the training were identified; these should be considered before implementation by other departments.

Explanatory Models of Burnout Diagnosis Based on Personality Factors in Primary Care Nurses

“…Ry in professional nursing times is inherent in the fact of feeling that they must contribute to a common good, especially in troubled times such as the COVID-19 pandemic [ 35 ]. The excess of Ry can decrease PA due to problems of motivation and job satisfaction and due to a lack of training [ 36 ]. To this excess of Ry should be added the lack of human and material resources as well as long working hours, which ends up affecting productivity and makes it difficult to meet their work objectives [ 20 , 37 , 38 , 39 ].…”

Topical review: Task shifting and the recruitment and retention of eye health workers in underserved areas

“…A lack of certainty over career progression and stability was also dissatisfying to task-shifted community eye care workers in Sierra Leone, 41 even though they were intrinsically motivated by a sense of helping their community. Nurses in an intravitreal injection training program in Norway 30 experienced task shifting more positively, finding that learning a new task provided a sense of pride, increased respect, and increased sense of involvement in patient care. These studies show that task shifting in eye care can be compatible with recruitment and retention when the new task provides deeper satisfaction and stability.…”

Australian Nurse Engagement in Eye Care: A National Survey

“…For example, nurses in other countries are already effectively performing extended practice (eg, intravitreal injections) to the benefit of those health systems and nursing professions. [10][11][12] Therefore, further work is needed to determine how the role of the Australian eye care nurse can be reimagined to effectively address the future demand of eye care services. To do so, a willingness on both sides of the "to" and "from" task exchange must occur.…”