Digital support for medication administration--a means for reaching the goal of providing good care?

Complexity and Knowledge in Organisational Context: Concepts, Approaches, Boundaries and Relations

The study sought to understand the relationship among organisations, knowledge and complexity so that managers could develop more effective strategies when working with organisational knowledge and complexity. The theoretical framework of the theme was elaborated from Web of Science and then an analysis of identified approximations, relations and boundaries was carried out. Aiming at greater consistency regarding the approximations and boundaries among the studied themes, we sought complex organisations that contemplated knowledge as a resource. The initial search retrieved 95 articles, and after content analysis was performed, we identified 25 articles considering complex organisations as social organisms and knowledge as a resource. In this sense, difficulties were observed regarding the definition of the concept of complex organisation, as well as regarding the understanding of knowledge as a resource. After the analysis of the 25 articles, eight pointed to some characteristic of complex organisations, and this corpus does now allow to relate and identify the impact of knowledge on complexity, or complexity on knowledge. From these considerations, we discuss ways to manage complexity and knowledge as elements inserted in the organisational context.

Technologies in older people’s care

Background:

The tension between care-based and technology-based rationalities motivates studies concerning how technology can be used in the care sector to support the relational foundation of care.

Objectives:

This study interprets values related to care and technologies connected to the practice of good care.

Research design:

This research study was part of a development project aimed at developing innovative work practices through information and communication technology.

Participants and research context:

All staff (n = 18) working at two wards in a care facility for older people were asked to participate in interviews, and 12 accepted. We analysed the data using latent content analysis in combination with normative analysis.

Ethical considerations:

The caregivers were informed that participation was voluntary and that they could drop out at any time without providing any explanation.

Findings:

Four values were identified: ‘presence’, ‘appreciation’, ‘competence’ and ‘trust’. Caregivers wanted to focus on care receivers as unique persons, a view that they thought was compromised by time-consuming and beeping electronic devices. Appraising from next-of-kin and been seen as someone who can contribute together with knowledge to handle different situations were other desires. The caregivers also desired positive feedback from next-of-kin, as they wanted to be seen as professionals who have the knowledge and skills to handle difficult situations. In addition, the caregivers wanted their employer to trust them, and they wanted to work in a calm environment.

Discussion:

Caregivers’ desire for disturbance-free interactions, being valued for their skills and working in a trustful working environment were interpreted as their base for providing good care. The caregivers’ arguments are based on caring rationality, and sometimes they felt the technological rationality interfered with their main mission, providing quality care.

Conclusion:

Introducing new technology in caring should support the caring relationship. Although society’s overall technology-based approach may have gained popularity as a problem solver, technology-based rationality may compromise a care-based rationality. A shift in attitudes towards care as a concept on all societal levels is needed.