Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study
Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study
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DOI：
10.1111/opn.12266
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发表时间：
2019-09-01
影响因子：
2.2
通讯作者：
Gagnon, Marie-Pierre
中科院分区：
文献类型：
--
作者：
Bourbonnais, Anne;Rousseau, Jacqueline;Gagnon, Marie-Pierre
目的探讨可能影响交互式移动的应用程序（app）和智能视频监控系统（IVS）在养老院（NH）中实施的条件及其使用的伦理挑战。背景有一个缺乏知识的实施技术在NHs和道德的挑战，可能会出现。在过去的研究中，护理团队表示需要提供临床支持的技术。像IVS和应用程序这样的技术可以证明在NHS中预防和管理福尔斯和响应行为是有用的。设计一个探索性的定性研究进行了护理管理者，家庭照顾者和正式照顾者在五个NHs。方法向每个参与者展示一个潜在的应用程序和一个IVS上的短视频。随后是一个半结构化的个人访谈。进行常规含量分析。结果-潜在的用户发现，这将是可能的，以实现这些技术，在国家卫生院，即使阻力可以预期。为了促进采用和实现临床效益，技术的实施应进行试点测试，并应计划指导活动。人们认为，即使没有技术，国家卫生机构也已经存在道德风险，例如隐私风险。例如，提出了调整道德守则和程序的战略。一些潜在的偏见的兴趣和能力的老年工作人员，护士的助手，和家庭照顾者使用技术被确定。结论通过严格和道德的实施，支持临床护理过程的技术可以使居住在NHS的老年人以及他们的亲属和工作人员受益。实践的影响提出了各种策略，以成功地实施技术。在执行过程中应努力避免偏见，并应调整程序以减轻可能的道德挑战。
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.