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Windle A, Marshall A, de la Perrelle L, Champion S, Ross PD, Harvey G, Davy C. Factors that influence the implementation of innovation in aged care: a scoping review. JBI Evid Implement 2023; 22:02205615-990000000-00072. [PMID: 38153118 PMCID: PMC11163893 DOI: 10.1097/xeb.0000000000000407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVE The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. INTRODUCTION Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care. INCLUSION CRITERIA This review included studies of any design, that examined the implementation of innovations in aged care settings. METHODS Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops. RESULTS Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies. CONCLUSIONS Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.
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Affiliation(s)
- Alice Windle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Amy Marshall
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Lenore de la Perrelle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Stephanie Champion
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Paul D.S. Ross
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Gillian Harvey
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Carol Davy
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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Frennert S. Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation. Disabil Rehabil Assist Technol 2023; 18:156-165. [PMID: 33151763 DOI: 10.1080/17483107.2020.1839579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM Technology affects almost all aspects of modern eldercare. Ensuring ethical decision-making is essential as eldercare becomes more digital; each decision affects a patient's life, self-esteem, health and wellness. METHODS We conducted a survey and interviews with eldercare professionals to better understand the behavioural ethics and decision making involved in the digital transition of eldercare. CONCLUSION Our qualitative analysis showed three recurrent roles among eldercare professionals in regard to digital service transformation; makers, implementers and maintainers. All three encountered challenging and stressful ethical dilemmas due to uncertainty and a lack of control. The matter of power relations, the attempts to standardize digital solutions and the conflict between cost efficiency and if digital care solutions add value for patients, all caused moral dilemmas for eldercare professionals. The findings suggest a need for organizational infrastructure that promotes ethical conduct and behaviour, ethics training and access to related resources.Implications for rehabilitationThe transition to digital care service is not neutral, but value-laden. Digital transformation affects ethical behaviour and decision-making.The decision as to which digital services should be developed and deployed must include eldercare professionals and not lay solely in the hands of managers, technologists and economists.We must move away from attempting to fit standardized solutions to a heterogenous group of older patients; accommodating the pluralism of patients' needs and wants protects their dignity, autonomy and independence.As digital care practices evolve, so too must organizational structures that promote ethical conduct.
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Affiliation(s)
- Susanne Frennert
- Department of Computer Science and Media Technology, Internet of Things and People Research Center, Malmö University, Malmo, Sweden
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Carnesten H, Wiklund Gustin L, Skoglund K, Von Heideken Wågert P. Battling extraordinary situations and conflicting emotions-A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic. Nurs Open 2022; 9:2370-2380. [PMID: 35633153 PMCID: PMC9348284 DOI: 10.1002/nop2.1250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/23/2022] [Accepted: 05/10/2022] [Indexed: 02/06/2023] Open
Abstract
Aim To describe newly graduated registered nurses’ (NGRNs’) experiences of encountering stress in emergency departments (EDs) during the COVID‐19 pandemic. Design A qualitative descriptive study. Methods Data from 14 in‐depth interviews with NGRNs working in an ED for 3‐36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden.,Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
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