229 General discussion 8 • Addressing the perceived added value of technology, while some nurses viewed the smart bed as "just a bed". This highlights the need for better promotion of benefits, ongoing involvement and clear communication. (Chapters 4 and 5) • Nurses faced both barriers and facilitators in adopting and keep using smart functions in medical beds. Barriers included complexity of use, perceived unreliability, questioning of the added value, and lack of connectivity within existing technological infrastructure. Facilitators included good availability of the beds, increased patient safety, and reduced physical burden for nurses. (Chapter 4) In chapter 4, the lack of connectivity emerged as a challenge. By connectivity, we refer to the ability of new technology to seamlessly integrate into the existing technological infrastructure. For example, bed-exit alarms should not only be heard in the room but should also trigger an alarm on the nurses’ call device. Without reliable connectivity, the smart functions of medical beds can not be fully utilized, leading to frustration and lower adoption rates among nursing staff. Addressing connectivity issues could involve investing in ensuring compatibility with existing systems, providing ongoing technical support, and better network infrastructure. By overcoming this barrier, we can enhance the usability and effectiveness of smart medical beds, ultimately improving patient care and nurse satisfaction. How can implementation science help bridging the gap between technological advancements and their practical application in nursing? Rigorous studies comparing different implementation strategies in different and similar contexts could identify either effective or ineffective strategies. For example, while educational meetings are widely used strategies, they have been found to only slightly improve compliance with desired practice when compared with no intervention [29]. Furthermore, the critical role of nurses in successful implementation of technological innovation has not gone unnoticed [30]. Co-developing and discussing innovations with nurses to ensure they align with their needs and improve practice requires motivated participants. However, it can be challenging to find motivated nurses, and keep them on board. Engaging nurses in co-designing dashboards or developing risk prediction models is challenging, as described in chapter 5. They often see such tasks as outside their job scope and feel they are neglecting patient care. Barriers like lack of time or knowledge are common, but further research should focus on ways to effectively engage nurses, gain understanding of whether experiencing a lack of time is related to prioritizing patient-care. It is interesting to distinguish between perception or choice. Additionally, exploring what motivates nurses to contribute to research and innovation and thereby investing in further developing their own field could yield valuable insights.
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