Table 2 Summary of findings on learning, usability and managing safety

Learning to use technology

Early experiences

• All had received extensive training 1-1

• All reported great support from home nurse and technician

• Most reported making mistakes in the early weeks, and being scared or panicking

Sources of learning

• Trial and error

• Learning from the nurse or technician

• From the manual

Being exposed to different practices

• The initial practice as taught

• Observing different nurses’ practices or attending a different dialysis unit

• Practices change over time

Usability

Troubleshooting

• Real-time pressure display helps with troubleshooting

• Some displays/alarms helpful for troubleshooting; others incomprehensible

The challenges of remembering

• 14/19 reported forgetting to open/close all clamps

• Several reported forgetting other details of the process

Accessibility for the patient

• Screen and controls need to be easily accessed by patient, as well as carers

• Display needs to be easy to read

• Clamps need to be easy to use

What don’t you like?

• The size and (lack of) portability

• The time around dialysis getting things organized

Safety

Overview

• All participants considered it safe

• All took care over infection control

• Several had experienced untoward incidents

• Most participants mentioned bubbles in the extracorporeal circuit

Strategies for staying safe

• Avoid distractions; do not do when tired

• Involve other people

• Anticipate water or power problems

• Give key to neighbour; keep mobile phone to hand

Troubleshooting

• Various creative strategies were reported to enable dialysis to proceed when machine was not functioning properly

Choosing quality of life

• People dialyse alone and when convenient, even if that reduces the available support

• Some choose quality of life (time/location) over ‘best practice’