Background: New social alarm solutions are viewed as a promising approach to alleviate the global challenge of an aging population and a shortage of care staff. However, the uptake of social alarm systems in nursing homes has proven both complex and difficult. Current studies have recognized the benefits of involving actors such as assistant nurses in advancing these implementations, but the dynamics by which implementations are created and shaped in their daily practices and relations have received less attention. Objective: Based on domestication theory, this paper aims to identify the differences in the perspectives of assistant nurses when integrating a social alarm system into daily practices. Methods: We interviewed assistant nurses (n=23) working in nursing homes to understand their perceptions and practices during the uptake of social alarm systems. Results: During the four domestication phases, assistant nurses were facing different challenges including (1) system conceptualization; (2) spatial employment of social alarm devices; (3) treatment of unexpected issues; and (4) evaluation of inconsistent competence in technology use. Our findings elaborate on how assistant nurses have distinct goals, focus on different facets, and developed diverse coping strategies to facilitate the system domestication in different phases. Conclusions: Our findings reveal a divide among assistant nurses in terms of domesticating social alarm systems and stress the potential of learning from each other to facilitate the whole process. Further studies could focus on the role of collective practices during different domestication phases to enhance the understanding of technology implementation in the contexts of complex interactions within a group.

Background Technologies such as social alarm systems contain expectations about how they should be integrated and used in practice. These expectations, also called technology scripts, usually fail to consider all the complexity in care practice. Shifting the focus from technology scripts to care practice, this paper examines how a social alarm system is used in assistant nurses' care practices in nursing homes. Methods The paper draws on observations of assistant nurses' daily tasks (32 h) and semi-structured interviews with assistant nurses (n = 12) in two Swedish nursing homes. The observation data were used to understand the care contexts and assistant nurses' technology-mediated care practices, while interviews were used to deeply understand assistant nurses' perceptions of the system, their care practices, and which aspects they considered during the provision of care. Findings We show the complexities involved in integrating a social alarm system into care practices based on assistant nurses' situational and personal interpretations of both technology scripts and quality of care. The technology-mediated care practices consist of receiving alarms from residents, checking alarms via alarm phones, responding to alarms via alarm phones, checking specific residents' situations in person, documenting all finished alarms, and documenting some finished alarms. In these practices, the assistant nurses defined technology scripts according to their expected requirements and outcomes, and meanwhile considered the quality of care by evaluating the priority of practical, moral or relational care in the situations at hand. Through further negotiations with the defined scripts and the considered quality of care, the assistant nurses decided on the final way of following (or not following) specific scripts in practice. Conclusion Results from our study portray the complexity of technology in care practices. The findings contribute to increased understanding of technology-mediated care practices in nursing homes, and research on technology scripts in institutional settings.

The worldwide shortage of qualified care workers along with the increasing need for elderly care services has restrained the capacity of nursing homes to offer their residents high-quality care services. Along with digitalization, policymakers believe that technological advancements can improve the efficiency of care and streamline care work, thus helping to alleviate the challenge above. These investments include the creation of new care services by adopting innovations such as social robots, and the update of existing care services by replacing analogue technologies with digital versions, such as social alarm systems. While numerous studies have discussed the implementation of new digital technologies, the digitalization of existing care services has received less attention.This dissertation conducts empirical investigations on the digitalization of social alarm systems in four Swedish nursing homes. By applying theories of social shaping of technology with a focus on socio-technical transformations in care practices, it asks how implementation of the new social alarm systems is socially shaped in care practices. The social alarm system is an established technology that aims to enable users to call for help in emergencies. Based on a literature review of the central theme (Paper I), the dissertation examines discrepancies between planned and actual implementation outcomes (Paper II), differences within a team during project executing (Paper III), and the relationship between individuals’ actual use of technology and the assumptions inscribed in the system and the diverse care concepts in nursing homes (Paper IV). The methodological basis of the dissertation comprises analysis of implementation documents, observations of healthcare professionals’ daily work, interviews with employees of both technology companies and nursing homes, questionnaires completed by healthcare professionals, and a literature review.The results reveal that technology implementation is far from predictable outside the care context. During the implementation process, people from different groups have distinct goals, focus on different facets, and develop diverse approaches for integrating the system into daily work. Frontline professionals determine their ways of using the new social alarm system based on their personal and situational understanding of technology scripts and care concepts under given contexts. The results contribute to theoretical clarifications as well as practical possibilities and limitations to guide the implementation of social alarm systems in nursing homes. The findings indicate that the introduction of a digital social alarm system brings various changes. The digitalization of social alarm services in nursing homes can benefit from a clear positioning of the new system, a common ground for sufficient communication between actors involved, and an in-depth interpretation of local environments, as well as flexible and continuous implementation strategies.

Den globala bristen på kvalificerad vårdpersonal tillsammans med det ökade behovet av äldreomsorgstjänster har begränsat vårdhemmens förmåga att erbjuda sina boende högkvalitativa vårdtjänster. Politiskt är tilltron hög till att digitaliseringen kan förbättra vårdens effektivitet, effektivisera vårdarbetet och därmed möta utmaningen med en växande äldrebefolkning. Nya vårdtjänster skapas med hjälp av digitala tillämpningar, till exempel sociala robotar, samtidigt som befintliga analoga vårdtjänster digitaliseras. Tidigare studier har framförallt fokuserat på implementeringen av helt nya digitala tekniker medan analog teknik som digitaliseras fått mindre uppmärksamhet. Avhandlingen omfattar empiriska studier av implementeringen av digitala larmsystem på fyra vårdboenden och har sitt huvudsakliga fokus på socio-tekniska förändringar i vårdens praktik, hur implementeringen av det nya larmsystemet formas socialt när den kontextualiseras. Larmsystemet är en etablerad teknik som syftar till att göra det möjligt för användare att ringa efter hjälp i nödsituationer. Baserat på en litteraturstudie (Studie I) undersöker bifogade artiklar förväntningarna på den tekniska förändringen uttryckt i roller, genomförandeplaner och strategier (Studie II); skilda uppfattningar inom ett team under genomförandet (Studie III); relationen mellan individernas faktiska teknikanvändning, de antaganden som tillskrivs tekniken från början och förekommande vårdideologi (Studie IV); samt individers roll i hanteringen av det nya systemet och vårdkulturen (Studie IV). Analysen av genomförandedokument, observationer av vårdpersonalens dagliga arbete, intervjuer med människor från både teknikföretag och vårdboenden, frågeformulär med vårdpersonal samt en litteraturöversikt bygger den metodologiska grunden för denna avhandling.Resultaten visar att ny teknik i vården är långt ifrån förutsägbar eller mätbar utanför den kontext där den implementeras. Under implementeringsprocessen har människor i organisationen olika mål, lägger vikt vid olika aspekter och har olika tillvägagångssätt för att integrera systemet i sitt arbete och sin vardag. Vårdpersonalen använder det digitala larmsystemet utifrån sin personliga och förståelse av tekniken, situationen och vården.Avhandlingens huvudsakliga bidrag handlar om teoretiska perspektiv såväl som praktiska möjligheter och begränsningar för implementeringen av sociala larmsystem på vårdboenden. Resultaten indikerar att digitaliseringen av redan kända analoga system medför olika förändringar. Digitaliseringen av larmtjänster på vårdboenden kan tjäna på en bättre kontextualisering av systemet; flexibla och kontinuerliga implementeringsstrategier; och en gemensam grund för ändamålsenlig kommunikation mellan involverade aktörer.

In certain parts of the world, medical waste is often stolen and sold during transportation, resulting in disease transmission and environmental pollution, which seriously affect people's health. Consequently, guaranteeing a safe and correct delivery of medical waste has a significant meaning. This article analyzes the problems of medical waste transportation management in Beijing Haidian Hospital. To assess the impact of deploying RFID technology, we established a transportation model, which includes three business modules: temporary storage and distribution, loading and transportation, uploading and disposal. At the same time, the role of such transportation model in solving problems was evaluated. On the basis of this, the social and economic benefits of the technical model are discussed and the shortcomings of the research are analyzed. We found that the RFID technology model could solve the problems existing in the transportation process of medical waste to a certain extent, and implement safe transportation management of medical waste. It provides some guidance on the practical application of the technical model.

Recent studies prove that when implementing new technology technology-driven and one-size-fits-all approaches are problematic. This study focuses on the process of implementing personal emergency response system (PERS) at nursing homes. The aim is to understand why the implementation of PERS has not met initial expectations. Multiple methods were used in two Swedish nursing homes, including document analysis, questionnaires (n = 42), participant observation (67 h), and individual interviews (n = 12). A logic model was used to ascertain the discrepancies that emerged between expected and actual implementation, and the domestication theory was used to discuss the underlying meanings of the discrepancies. The discrepancies primarily focused on staff competence, system readiness, work routines, and implementation duration. Corresponding reasons were largely relevant to management issues regarding training, the procurement systems, individual and collective responsibilities as well as invisible work. The uptake of technology in daily practice is far more nuanced than a technology implementation plan might imply. We point out the importance of preparing for implementation, adjusting to new practices, and leaving space and time for facilitating implementation. The findings will be of use to implementers, service providers, and organizational managers to evaluate various measures in the implementation process, enabling them to perform technology implementation faster and more efficiently.

Seeking effective approaches to integrate technology into formal healthcare professionals’ daily works has been acknowledged as challenging. The purpose of this article is to provide a comprehensive overview of the recent research concerning the implementation of personal emergency response systems (PERSs), with the focus on the routine use of PERS among formal healthcare professionals, as well as identify current gaps in this area. The scoping review followed the five-stage framework of Arksey and O’Malley and PRISMA-Extension for Scoping Reviews (PRISMA-ScR). Searches were performed in PubMed, CINAHL, EMBASE, and the Web of Science Core Collection for studies published from 2009 to 2019. Any peer-reviewed studies in English describing strategies, barriers, and facilitators, or assessing the impact of integrating PERS into healthcare professional practices fulfilled the inclusion eligibility. Two reviewers screened the manuscripts and extracted data independently, with a third reviewer resolving discrepancies. Due to a large heterogeneity of included studies, a narrative synthesis was conducted. In total, 25 studies were included out of 2,319 manuscripts. This study discusses supportive strategies, and enabling and inhibiting factors, as well as integration outcomes. Future studies can contribute to three gaps by examining: 1) how strategies such as training contribute to the effectiveness of technology integration separately and collectively; 2) how working environments affect the effectiveness of realizing operational works; and 3) how technology is shaped by social environments and relationships. 

Methods to involve users in design have long been used to create relevant content and increase the accuracy of product development. Demographic trends have raised the issue of the needs and demands of older people, especially with regard to digitization. In contrast to the high number of publications discussing the importance of involving people in the design of their daily life, very few publications suggest how to do it. While participatory design is used with older people, there is no common understanding about which methods are used for what purposes. This paper presents a framework methodology that further advances the opportunity to involve older people in the design process and increase understanding of old people’s subjective experience of getting their lives digitized and how to involve them in design. Given that digitalization, with its systemic complexity, requires an understanding of how technology is contextualized, the need to understand what it means to age in today’s digital society is part of successful design. One objective is to go beyond stereotypes that often characterize generalizations of older people. We are using the concept of co-design, which is well established but not specifically adapted to older users. The goal is a matrix of tested co-design methods to be used by citizens, researchers, businesses or anyone who is interested in increasing the impact of old people on the design of new technologies.

Although health monitoring systems in smart homes have been revealed as a significant tool to help people ageing in place, the density of data poses a challenge on the information visualization. This review aims to make contributions to find gaps in the field of information visualization regarding smart home monitoring for older people. Three kinds of information needs of older adults and their informal caregivers regarding smart home monitoring are categorized, including physical needs, emotional needs and cognitive needs. The research studies reflect that these needs are mainly used to discuss ideas of, design approaches for, the information visualization from ten aspects in the visceral level, behavioral level and reflective level. Results show that there is still a big gap existing in enabling older people and their informal caregivers to better understand smart home monitoring information. Some existing design recommendations can be improved while at the same time, some needs have not been manifested through information visualization. A wider understanding of older adults, informal caregivers and home living environment in all aspects are necessary.

The increasing global aging population has highlighted the need for qualified elderly care services. The shortage of care services presents challenges in meeting these increasing demands. The Personal Emergency Response System (PERS), a telehealth technology, is seen as a solution to improve care quality by simplifying care tasks. However, the complexity of PERS adoption and care workers' concerns about using the technology in care work are rarely addressed. This study applies the Actor Network Analysis, Action, Factor and Goal (AFG) model to understand careworkers' behaviors regarding PERS in nursing homes, focusing on operational and perceptual levels. Our findings reveal that PERS use involves two key areas: software interaction with residents and colleagues, and hardware implementation. Three operational disparities were identified, and the care workers' perceptions during the adoption process were discussed. The AFG model helps identify gaps in PERS use, providing a clearer context for caregivers' experiences. This research offers valuable insights for aging care scholars and practitioners, helping them better understand the challenges care workers facing with innovative technologies. Additionally, it provides PERS providers with a broader view of caregivers' and elderly residents' needs. By recognizing operational and perceptual barriers, this study can support a smoother integration of PERS into nursing home care.

Background: New social alarm solutions are viewed as a promising approach to alleviating the global challenge of an aging population and a shortage of care staff. However, the implementation of social alarm systems in nursing homes has proven both complex and difficult. Current studies have recognized the benefits of involving actors such as assistant nurses and middle managers in advancing these implementations, however the differences in their perspectives during the implementation of these novel technologies have received less attention.Methods: Based in domestication theory, this paper aims to better understand the perspectives of middle managers and assistant nurses during four domestication phases. We interviewed middle managers (n = 5) and assistant nurses (n = 17) working in nursing homes to understand the two groups’ perceptions and practices during the implementation of social alarm systems.Results: During the four domestication phases, a total of four differences in perspectives emerged between the groups, including (a) system conceptualization; (b) spatial employment of social alarm devices; (c) treatment of unexpected implementation issues; and (d) evaluation of inconsistent competence in technology use. Our findings elaborate how individuals from the two groups have distinct goals, focus on different facets, and develop diverse coping strategies over time. Taking a closer look into middle managers’ and assistant nurses’ ways of overcoming these differences, we propose a tentative concept: “collective domestication“ to call for more studies about collective practices during technology domestication within organizations.Conclusion: Our findings reveal a divide between middle managers and assistant nurses in terms of domesticating social alarm systems and stress the potential of learning from each other to facilitate the whole process. Further studies could focus on the role of collective practices during different domestication phases to enhance the understanding of technology implementation in the contexts of complex interactions across groups.