Recommendations on teaching medical and nursing tasks to patients and informal caregivers: a Delphi study

Abstract Introduction . Patients and informal caregivers are increasingly being approached as equal members of the healthcare team and are performing medical and nursing tasks independently. However, patients and informal caregivers feel under-equipped to independently execute medical and nursing tasks, leaving them underprepared and overburdened. Therefore, this study aims to formulate consensus-based recommendations on the organization, training, and transfer of medical and nursing tasks to patients and informal caregivers. Methods . A Delphi study was conducted among experts with backgrounds as policymakers, healthcare professionals, and researchers in health and/or social care, or as patients and informal caregivers. An initial set of 54 statements was drafted, categorized into four categories: (1) on strategy for health and social care organizations, (2) on the logistical prerequisites, (3) on eligibility criteria for patients and informal caregivers, and (4) on training and transferring medical and nursing tasks. Results . 43 experts participated, of whom 36 were professionals from health or social care: policymakers (26%), providers (30%), researchers (28%). Additionally, recipients of health or social care participated: 7 in a primary professional role and 5 in a secondary role alongside their professional role (N=12, 28%). Together, they reached consensus on 45 recommendations across three rounds. Most recommendations (n=26) focused on the process of training and transferring of medical and nursing tasks to patients and informal caregivers. Conclusions . The recommendations emphasize the need for a health care organization’s strategic vision on collaborative practice that facilitates equitable relationships among professionals, patients, and informal caregivers. Healthcare professionals were considered responsible for providing reliable, accessible, and understandable information and for delivering face-to-face training sessions. Simultaneously, patients and informal caregivers were considered responsible for the safe performance of the medical or nursing task at hand within the scope of their training and for consulting a healthcare professional when in doubt. Experts warn for the instrumentalization of patients and informal caregivers, and the subsequent burden on them, amid rising health staff shortages, underscoring the need for a balanced partnership among all actors.