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. 

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.

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.

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 hours) 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.

Results: 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. In technology-mediated care practices, consisting of receiving alarms from residents, checking alarms, responding to alarms and documenting finished alarms, 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 using (or not using) the system in practice.

Conclusion: Results from our survey 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 normative settings.