108 Chapter 4 protocol. In 2023, three fall detection alarms were activated, but, as in 2020, none had their communication cables connected. A nurse shared insights into the barriers to using this function in the questionnaire, stating: “Cancelling the activation of the function often requires too much effort. If the function is linked to the Myco [the nursing call system], the signal is the same as assistance/resuscitation.” Participant 385 Head-of-bed-angle alarm During all observations, none of the beds had an activated head-of-bed-angle alarm. In 2023, all nurses reported either not using or being unaware of this function. A nurse shared insights into the barriers to using this function in the questionnaire, stating: “No communication possible with Myco, On the ICU, a quick change in position is sometimes necessary. First turning off an alarm does not work and is therefore never used.” Participant 341 Chair position Patients were asked whether they had experienced the bed being adjusted into the chair position. In 2020, 27% reported experiencing this, compared to 21% in 2023. Notably, no patients were observed in the chair position in 2020, while in 2023, four percent of the patients were in chair position during observation. Mechanisms of impact Patients generally reacted positively to the beds and the smart functions, giving the beds a median rating of 7 (IQR 6-8) on a scale of 0 to 10. While 70% of patients reported not receiving an explanation about how to use the bed, most also stated that an explanation was not necessary. Nurses’ reactions to the smart functions varied. Among nurses familiar with the old beds (n=97/116), 72% agreed or strongly agreed that the new beds represented an improvement. Specific barriers and facilitators for each function are detailed in Table 6. For each function, nurses mentioned various facilitators that supported their use. For instance, regarding the chair function, one nurse noted: “For patients who have difficulty mobilizing, [the chair function] allows for positioning in a sitting position [without needing to transfer from the bed to a chair].” Respondent 165
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