Conditions and ethical challenges that could influence the implementation of technologies in nursing homes : a qualitative study
Article [Accepted Manuscript]
Is part of
International journal of older people nursing ; vol. 14, no. 4.Publisher(s)
WileyAuthor(s)
Abstract(s)
Aim: To explore the conditions that may influence the implementation of an interactive
mobile application (app) and an intelligent videomonitoring system (IVS) in nursing
homes (NHs) and the ethical challenges of their use.
Background: There is a lack of knowledge about implementing technologies in NHs
and the ethical challenges that might arise. In past studies, nursing care teams
expressed the need for technologies offering clinical support. Technologies like an IVS
and an app could prove useful in NHs to prevent and manage falls and responsive
behaviours.
Design: An exploratory qualitative study was conducted with care managers, family
caregivers, and formal caregivers in five NHs.
Methods: Each participant was shown a presentation of a potential app and a short
video on an IVS. It was followed by an individual semi-structured interview. A
conventional content analysis was performed.
Findings: Potential users found it would be possible to implement these technologies
in NHs even if resistance could be expected. To facilitate adoption and achieve clinical
benefits, the implementation of technologies should be pilot-tested, and coaching
activities should be planned. Ethical risks were considered already present in NHs even
without technologies, for example, risks to privacy. Strategies were proposed, for
instance, to adapt the code of ethics and procedures. Some potential prejudices about
the interest and abilities of older staff, nurses’ aides, and family caregivers to use
technology were identified.
Conclusions: Through rigorous and ethical implementation, technologies supporting
clinical care processes could benefit older people living in NHs, as well as their relatives
and the staff.
Implications for practice: Various strategies are proposed to successfully implement
technologies. Effort should be made to avoid prejudices during implementation, and
procedures should be adapted to mitigate possible ethical challenges.
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