Training for the Intraspinal Drug Delivery System Reservoir Refill Procedure Highly Variable: A Nationwide Survey of Health Care Professionals

Objectives: This study describes the training, experience with pocket fills, and life-long learning behaviors in a national sample of health care professionals who perform the reservoir refill procedure and compares results with intraspinal drug delivery morbidity and mortality clinical practice guidelines to demonstrate the need for standardized training. Methods: Using a cross-sectional, descriptive design and a 23-item questionnaire administered via social media, 65 health care professionals who performed the reservoir refill procedure within the last year were surveyed. Descriptive and inferential statistics were used for analysis. Results: Our results showed: 1) training varied widely and lacked supervision and mentoring for the inexperienced clinician, 2) the highest number of pocket fills was reported by the most experienced clinicians, and 3) there was limited participation in professional meetings where intraspinal therapy is discussed. The use of intraspinal drug delivery clinical practice guidelines significantly increased in current practice compared to use during training. Conclusion: Training for the reservoir refill procedure was highly variable, inconsistent with intraspinal drug delivery clinical practice guidelines' training recommendations with a high number of pocket fills, and low participation in national intraspinal drug delivery meetings. Standardized training is needed to reduce variability and minimize the risk for human error during the reservoir refill procedure.