BackgroundThe healthcare system faces a major challenge in caring for an increasingly ageing population as this task requires more resources than are currently available. Adopting monitoring technologies could enable more efficient care practices and support ageing in place.Objectives To investigate how the use of an in-home motion monitoring system can be integrated into home care nurses' workflows and to uncover the factors behind system adoption.Design A single case study adopting a qualitative approach.Setting A home care unit serving older adults living in independent living residences within an apartment complex.Method Multiple data collection methods were used including individual and group interviews, a questionnaire with open-ended questions, evaluation probes, and system log data. The qualitative material was analysed using a stepwise-deductive inductive approach.Results A central factor behind system adoption was the perceived usefulness of gaining information about older adults' night-time activities. In particular, monitoring older adults suffering from memory disorders was considered advantageous. The information that the system provided supported nurses in health assessments and assisted in adjusting care decisions. Previous negative experiences with similar technologies initially influenced the time for adoption. Further, although nurses were closely involved in the system design process, they took some time to get acquainted with the system and to integrate its use into daily practice. System reliability and accuracy issues influenced nurses' trust in the sensory data.Conclusion The findings suggests that in a home care setting, focusing on motion pattern monitoring for older adults with memory disorders can provide significant benefits and therefore also facilitate system adoption among nurses. Involving nurses in the design of the technology and providing opportunities to trial the system in real practice also appear to be important in achieving system adoption. 65 compatibility, complexity, trialability, and observability (Rogers, 1983). Relative advantage refers to how potential users perceive the innovation as an advantage over existing alternatives. For example,
Abstract-For a comprehensive information coverage across theatre, it is necessary to integrate many different sources of data which are likely to use protocols specific to a specialised purpose. For example, resource-constrained or challenged networks such as sensor systems and MANET systems, using their own protocols, may be used in conjunction with other Internet Protocol (IP) based communication and need to be integrated into the GIG. While such integration may be possible today, the engineering is complex and the resultant system may be difficult to configure and maintain, as well as being brittle when systems changes or reconfiguration is required. Furthermore, when security and identity issues are considered, the additional overhead for enabling integration within the context of sensor systems and MANETs raises challenging technology issues. Based on our ongoing work, we present a potential solution which organises such systems based on identity and location, but allows integration with Internet-wide communication.
Nurse calls in a hospital can constitute either positive or negative (wanted or unwanted) interruptions depending on various factors. This study aims to understand nurses' strategies in facilitating the reception of wanted nurse calls and the restriction of unwanted nurse calls. Applying a resilience engineering perspective, nurses' performance variability is investigated as a basis to design appropriate computer support to enhance efficiency and patient safety. A qualitative case study was conducted for a period of 4 years with focus on nurses' use of a wireless nurse call system at a Norwegian university hospital. The study involved various data collection methods such as observations, interviews, and workshops. The collected data were then transcribed and analyzed using a combined inductive and deductive approach. Results indicate that nurses use four main strategies involving a large degree of collaboration to allow or avoid interruptions in the form of nurse calls depending on situation and circumstances. However, these strategies are not supported by the wireless nurse call system, which requires nurses to use suboptimal workarounds to enable the necessary performance variability. Interruptions have been largely perceived as a threat to patient safety. However, nurses' handling of calls illustrates that, when aiming to introduce interventions to manage interruptions, a detailed understanding of work as done is important. Nurses continuously make appropriate adjustments to cope with challenges that characterize hospital work to ensure efficient and safe operations. Hence, technology, in terms of a nurse call system, needs to be designed to afford the adjustments made to support a resilient practice and, as such, leverage patient safety.
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