Safety for older adults using telecare: Perceptions of homecare professionals

Johannessen, Torunn Beate; Storm, Marianne; Holm, Anne Lise

doi:10.1002/nop2.328

Cited by 20 publications

(39 citation statements)

References 29 publications

(45 reference statements)

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“…Our finding that safety technology is the most prevalent type can also be explained by the fact that ensuring patient safety is a top priority in global health [ 54 ] and a key expectation for welfare technology from the perspectives of both the government [ 19 ] and care professionals [ 61 ]. Furthermore, the concept behind welfare technology is remote patient monitoring, focusing on the personal safety of the individual [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Integrating Welfare Technology in Long-term Care Services: Nationwide Cross-sectional Survey Study

Rostad¹,

Stokke²

2021

J Med Internet Res

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Background Welfare technologies are often described as a solution to the increasing pressure on primary health care services. However, despite initiating welfare technology projects in the health care sector and different government incentives, research indicates that it is difficult to integrate welfare technology innovations in a complex and varying setting, such as long-term care. Objective We aim to describe the types of welfare technology and the extent to which welfare technology is provided in long-term care (ie, nursing homes and home care services); examine whether the extent of welfare technology provision differs on the basis of municipal characteristics (ie, population size, centrality, the proportion of older inhabitants, and income); and identify how local governments (ie, municipalities) describe their efforts toward integrating welfare technologies in long-term care. Methods Quantitative and qualitative data about welfare technology from a larger cross-sectional survey about the provision of long-term care services in Norwegian municipalities were combined with registry data. Representatives of 422 Norwegian municipalities were invited to participate in the survey. Frequencies were used to describe the distribution of the types and extent of welfare technologies, whereas the Fisher exact test and Kruskal-Wallis one-way analysis of variance were used to determine the association between the extent of welfare technology and municipal characteristics. Free-form text data were analyzed using thematic analysis. Results A total of 277 municipalities were surveyed. Technology for safety was the most widespread type of welfare technology, whereas technology for social contact was the least prevalent. Two-thirds of the sample (183/277, 66.1%) in nursing home and (197/277, 71.1%) in home care services reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (in both nursing homes and home care services: P=.01), centrality (nursing homes: P=.01; home care services: P<.001), and municipal income (nursing homes: P=.02; home care services: P<.001). The extent of welfare technology was not associated with the proportion of older adults. The municipalities described being in a piloting phase and committing to future investment in welfare technology. Monetary resources were allocated, competency development among staff was initiated, and the municipalities were concerned about establishing collaborations within and between municipalities. Home care services seem to have a more person-centered approach in their efforts toward integrating welfare technologies, whereas nursing homes seem to have a more technology-centered approach. Conclusions Many municipalities provide welfare technologies; however, their extent is limited and varies according to municipal characteristics. Municipal practices still seem dominated by piloting, and welfare technologies are not fully integrated into long-term care services. Innovation with welfare technology appears top-down and is influenced by national policy but also reflects creating a window of opportunity through the organization of municipal efforts toward integrating welfare technology through, for example, collaborations and committing personnel and financial resources.

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Section: Discussionmentioning

confidence: 99%

Integrating Welfare Technology in Long-term Care Services: Nationwide Cross-sectional Survey Study

Rostad¹,

Stokke²

2021

J Med Internet Res

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“…Telecare is often promoted as an easy fix to the increasing pressure to deliver high-quality services to ever more patients with ever greater needs [8,14]. Previous research on 'technology in use' in other parts of health care shows that gainful implementation of technology in work practices must handle the intricate and rather unpredictable relationships between people and technologies [9,15,16].…”

Section: Patient Safety Through Technologymentioning

confidence: 99%

“…Our research is based on an empirical study in five Norwegian municipalities where we employ theoretical perspectives of technology in practice, i.e., perspectives investigating the dialectic relationship between technology and its users in health care (Timmermans and Berg, 2003). Through a discussion drawing on such contributions from Pols, Greenhalgh and Johanessen [9,15,16]. By doing so, we aim to provide insight into what this safety work implies and how it is performed in day-today care work.…”

Section: The Social Alarmmentioning

confidence: 99%

A qualitative study of what care workers do to provide patient safety at home through telecare

Stokke

Melby

Isaksen

et al. 2021

BMC Health Serv Res

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Background In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Telecare is one of the fastest-growing technology-domains in western health care systems. In the marketing of telecare, the expectation is that safety is implicit simply by the presence of technology in patients’ homes. Whilst both researchers and health authorities are concerned with developing cost-benefit analyses and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies contribute to patient safety. This paper aims to describe how patient safety in home care is addressed through and with telecare. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. Methods The study has a qualitative explorative design where we draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. We analyse observations of practice and interviews with the actors involved, following King’s outline of template analysis. Results We identified three co-existing work processes that contributed to patient safety: “Aligning people and technologies”; “Being alert and staying calm”; and “Coordinating activities based on people and technology”. Attention to these work processes exposes safety practices, and how safety is constructed in relational practices involving multiple people and technologies. Conclusions We conclude that the three work processes identified are essential if the safety alarm is to function for the end user’s safety. The safety of home-dwelling patients is reliant on the person-technology interface. The efforts of care workers and their interface with technology are a central feature of creating safety in a patient’s home, and in doing so, they utilise a repertoire of skills and knowledge.

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“…For at teknologien skal fremme pasientsikkerheten, må det tas høyde for brukerens evner, ferdigheter og ressurser. I motsatt fall kan utfordringer ved bruk av teknologi føre til pasientskade (Johannessen, Storm & Holm, 2019). Guise et al (2014) oppsummerer at bruk av velferdsteknologi har vaert relatert til manglende kunnskap og forståelse hos både brukere og ansatte, teknologiske problemer, endringer i arbeidsmengden, manglende retningslinjer, dårlig systemintegrering og hjemmemiljø, for å nevne noen.…”

Section: Velferdsteknologi Og Pasientsikkerhet I Utaktunclassified