109 Barriers and Facilitators Associated with the Implementation of Technical Improvements in Medical Beds 4 Nurses expressed several criticisms and identified barriers to using the smart functions of the beds in practice. Several nurses reported that unlocking the bed’s screen was overly complicated, which hindered their ability to access the smart features. Additional barriers included the placement of the buttons, the slow response time when pressing them, and the need to continuously hold a button in a non-ergonomic manner to achieve the chair position. Furthermore, many nurses were unaware of certain functions, particularly the chair position and the head-of-bed-angle alarm. A recurring observation shared by stakeholders during interviews was that nurses often stick to their old habits and do not actively seek to learn about the bed’s features. There was also skepticism about the usefulness and reliability of these features, with many nurses finding them less user-friendly than expected. As one manager stated in an interview: “In general, people are somewhat disappointed with the new hospital because the initial promises about what would be possible have not been met… We simply don’t do it [using functions that disappoint]. While people are quite open to technical innovations, these fall short of expectations in the end.” Manager As a result, nurses often revert to using a weighing chair instead of the bed’s integrated weight function. Additionally, protocols are not consistently followed, with nurses preferring to investigate solutions on their own or seek assistance from colleagues rather than consulting a protocol first. All stakeholders emphasized the importance of keeping in mind that “it is just a bed”– it should be easy to use, easy to understand, and should not require extensive training, specialized skills or detailed protocols, unlike equipment such as an intravenous infusion pump. As the clinical advisor stated: “But in reality, uh, that’s just not possible [providing education over and over to every nurse]– we have to accept that. As I often say, at the end of the day they’re just beds, right? And, even without training, you press a few buttons and you can get started.” Clinical advisor On the other hand, however, the key users and the clinical advisor underlined the importance of really understanding the bed’s functions: “You really have to understand how the bed works.” Key user “Everyone I train says, ‘Wow, what a great bed, so convenient’ [like they wouldn’t have known about these functions without the training]. I hardly hear any negative feedback. Yes, some people have opinions about the mattress, but they’re already working on that.” Clinical advisor
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