107 Barriers and Facilitators Associated with the Implementation of Technical Improvements in Medical Beds 4 Implementation – Reach During both data collection periods, nearly all patients were observed in a smart bed, with exceptions for those requiring special care beds (e.g., obesity beds). Eighty percent of the key users conducted on-the-job training sessions on their respective wards. Each key user provided a median of 6 (IQR 3-10) sessions, with a median duration of 20 minutes (IQR 15-30), involving 1 to 10 nurses. According to the questionnaire responses, most nurses reported that they had participated in an on-the-job training session. The majority agreed or strongly agreed (78.6%) that they were confident in using all bed functions after training. However, in 2023, there was a slight decline in the proportion of nurses who received an educational session, dropping to 61.3%. Implementation – Dose and fidelity Weight function Initially, twenty-six percent of the nurses reported using the integrated weight function weekly or more frequently, which increased to 67% in 2023. Among patients whose weight was measured, 39% in 2020 and 59% in 2023 indicated that the measurements were performed using the bed's integrated weight function. In 2020, the weight chair (51%; 25/49) and a regular scale (16%; 8/49) were frequently available. By 2023, several nurses indicated that there were less alternatives, the weight chair (19%) or a regular scale (22%) were used less frequently. Although 75% of nurses agreed that the bed’s weighing function contributes to better patient care, 38% perceived it as unreliable in practice. A ward nurse shared the following remark regarding the use of the weight function: “Most people need to be weighed regularly. We also have the passive lift [available in every room DS], to which you can also attach a scale. I know that we weigh most of the heavy patients this way. And if the patient can stand, then on a scale, yes. I once used the scale in the bed because it had already been zeroed [calibrated].” Ward nurse The observations suggest that the weighing function was not being utilized optimally. The median number of days between the last calibration and the observation was 16 (IQR: 7-34), even though calibration should be performed regularly. The median time since the last stored weight was 103 days (IQR 37-204). This is in contrast to 80% of nurses (n=87/109) who reported using the weighing function according to protocol. Fall detection alarm Of the 194 beds observed in 2020, only one had an activated fall detection alarm. While the alarm was configured to detect a patient’s intention to leave the bed, the communication cable was not connected to the nursing call system, contrary to
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