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 Nurse call systems (NCS) encompass all patients and nursing staff in healthcare facilities. Wireless NCSs offer increased mobility for all users and new affordances to patients unable to actively interact with such systems. Integrated technology potentially decrease response times and prevent alarm-fatigue, and thus increase patient safety and enhance nursing workflow. This study aimed to explore facilitators and barriers for implementation of wireless NCSs in residential care facilities. Methods The study had a cross-sectional descriptive design. Using a questionnaire, we collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovations (MIDI) in five Norwegian residential care facilities during the first year of implementation of wireless NCSs. Descriptive statistics were used to explore participant characteristics and MIDI 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=23) than barriers (n=6) were identified. No features of the technology itself were found to impede the implementation. The most salient barriers, reported by 37% of the care providers, were their lack of prior knowledge and that they found the wireless NCS difficult to learn. However, 87% became familiar with the systems during implementation. Respectively, 86% and 90% regarded themselves and their colleagues as competent users after the implementation. The greatest facilitators, reported by 98%, were firstly the normative belief of unit managers and secondly the expected outcomes of the NCSs: the importance and probability of achieving prompt call responses and increased safety. Conclusions The wireless NCSs were well received and the implementations were satisfactory executed. 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. Wireless NCSs offer a range of advanced applications and services, and further research is needed as more wireless NCS functionalities are implemented into residential care services.
