EXPLORING THE ADAPTIVE AND TECHNICAL CHALLENGES NURSING STAFF EXPERIENCE IN USING NEW TECHNOLOGY

摘要

The Pressure ulcer prevention (PrU) care standard for U.S. nursing home (NH) residents is repositioning every 2 hours to minimize pressure exposure; however, on-time repositioning nursing staff compliance is low. This study examined the adaptive and technical challenges nursing staff faced when using new technology to facilitate repositioning of NH residents. A 21-day trial with a convergent mixed methods pre/post-test design compared resident and staff outcomes at a southeastern US NH. The Leaf® Patient Monitoring System, a wireless system with sensor worn mid-sternum tracks (position, repositioning frequency; enabling percentage of on-time compliance calculation) resident movement 24-hours a day, cueing staff when repositioning is required. Web-based surveys completed by staff (RNs, LPNs, CNAs) pre/post intervention were the Nursing Culture Assessment Tool (NCAT), Perceived Organizational Support (POS), and Affective Organizational Commitment (AOC). During post-intervention focus groups (2, n=13), staff perspectives were gathered. NH staff data and Leaf® monitoring data were quantitatively analyzed. Qualitative analyses using transcribed focus group sessions identified core concepts, applied satisfaction-based apriori codes, and allowed emergence of new themes. Staff on-time repositioning compliance improved from 59.8 to 77.3%. Staff responded positively to repositioning cues and described an enhanced sense of teamwork in order to achieve on-time repositioning, believing that usual care was provided faster. Adaptive and technical challenges will be discussed. Nursing culture’s normative ranking percentage increased and communication, satisfaction, and professional commitment item scores positively corresponded with focus groups. Also, POS and AOC scale scores improved. Triangulated findings revealed nursing staff’s enhanced experience by using new technology.