Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study

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.