Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

Abstract

Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety, and the normative belief of unit managers. During the implementation process, 87% became familiar with the systems, and 86% and 90%, respectively regarded themselves and their colleagues as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge and that they found the WNCS difficult to learn. No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

Implementation and experience of an innovative smart patient care system: a cross-sectional study

“…In this study, we observed 35.2% of false alarms in TPCS and 0% in SPCS. The high predictive positive value of SPCS significantly improves nursing staff’s willingness to use the system which may be another reason that SPCS has a positive effect on fall prevention [ 54 , 55 ].…”

“…Future work should also collect data from patients and their family members. Lastly, many factors can affect nurses’ response time such as ward architecture, route length, conditions of nurses [ 36 , 54 ]. These potential influencing factors were not taken into analysis in the present study which could cause bias for the impact of the SPCS on the attitude, experience, and response time of nurses.…”

The barriers and facilitators of radical innovation implementation in secondary healthcare: a systematic review

“…In addition, the three articles used new skills and competences and implemented a system in their organization (i.e. an intelligent care system (Tanniru et al, 2018), a supply-driven longterm care system (Cramer et al, 2014), or a wireless nurse call system (Dugstad et al, 2020)). Therefore, it is debatable whether these innovations are radical, as these innovations have several characteristics that are more in line with the characteristics of an incremental innovation.…”

“…Our study shows that training in radical innovation implementation should entail tailored information in order to apply it into the staff's routines. Furthermore, practical handling of the new innovation by learning from other professionals and programs that have similar interest and visions, is found to be useful (Cramer et al, 2014;Dugstad et al, 2019Dugstad et al, , 2020Soderholm and Sonnenwald, 2010). In both secondary and primary healthcare, external partnerships and inter-organizational collaborations do not only assist radical healthcare innovation implementation in a social exchange, but also in securing resources and the development of new skills and evidence (Barnett et al, 2011;Mikhailova, 2018).…”