Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study
BackgroundTechnology that detects early when a patient at risk of falling leaves the bed can support nurses in acute care hospitals. ObjectiveTo develop a better understanding of nurses’ perspectives and experiences with a bed-exit information system (BES) in an a...
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JMIR Publications
2025-02-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e64444 |
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| author | Stefan Walzer Isabel Schön Johanna Pfeil Sam Klemm Sven Ziegler Claudia Schmoor Christophe Kunze |
| author_facet | Stefan Walzer Isabel Schön Johanna Pfeil Sam Klemm Sven Ziegler Claudia Schmoor Christophe Kunze |
| author_sort | Stefan Walzer |
| collection | DOAJ |
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BackgroundTechnology that detects early when a patient at risk of falling leaves the bed can support nurses in acute care hospitals.
ObjectiveTo develop a better understanding of nurses’ perspectives and experiences with a bed-exit information system (BES) in an acute care hospital setting.
MethodsBES was implemented on 3 wards of a university medical center. Nurses completed 2 online surveys at each time point (P0 and P1) and participated in focus groups before (P0) and after (P1) implementation. Additional patient data were collected. Descriptive statistics summarized the survey results, while content analysis was applied to focus group data. Patient rates and adverse events in both phases were compared using negative binomial models. Reporting of this study adhered to the GRAMMS checklist.
ResultsA total of 30 questionnaires were completed at P0 (30/72, 42%) and 24 at P1 (24/71, 33%). Of the participants, 15 completed both questionnaires (complete cases). At P1, 64% (9/14) of participants agreed that their perceived workload and strain in caring for patients with cognitive impairment was reduced by the use of the BES. The adverse event rate per patient per day was reduced by a factor of 0.61 (95% CI 0.393-0.955; P=.03). In addition, 11 nurses participated in 4 focus groups before and after the intervention. Participants found it challenging to operationalize the use of the BES due to the heterogeneity of care settings, but certain behaviors of patients with cognitive impairment were recognized as indicating a need for intervention. Negative experiences included information overload and alarm fatigue, leading to occasional removal of the system.
ConclusionsWhile BES provides some support in managing patients with cognitive impairment, its impact remains limited to specific scenarios and does not significantly reduce nurses’ workload or strain. Our findings highlight the need to manage expectations of BES performance to ensure alignment between expected and actual benefits. To improve BES effectiveness and long-term implementation, future research should consider both objective measures of patient care and subjective factors such as nurse experience, structural conditions, and technical specifications. Improving information mechanisms within call systems could help reduce alarm fatigue and increase perceived usefulness. Overall, successful integration of BES in acute care settings will require close collaboration with nursing staff to drive meaningful healthcare innovation and ensure that the technology meets the needs of both patients and nurses.
Trial RegistrationGerman Register for Clinical Studies DRKS00021720; https://drks.de/search/de/trial/DRKS00021720 |
| format | Article |
| id | doaj-art-dd8d068229c744c391fe243d5b572fae |
| institution | Kabale University |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj-art-dd8d068229c744c391fe243d5b572fae2025-02-05T13:31:32ZengJMIR PublicationsJMIR Formative Research2561-326X2025-02-019e6444410.2196/64444Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods StudyStefan Walzerhttps://orcid.org/0000-0002-8748-5244Isabel Schönhttps://orcid.org/0009-0007-7089-650XJohanna Pfeilhttps://orcid.org/0009-0009-2721-8425Sam Klemmhttps://orcid.org/0009-0001-0676-2896Sven Zieglerhttps://orcid.org/0000-0003-1932-0787Claudia Schmoorhttps://orcid.org/0000-0001-5610-9425Christophe Kunzehttps://orcid.org/0000-0002-2238-5533 BackgroundTechnology that detects early when a patient at risk of falling leaves the bed can support nurses in acute care hospitals. ObjectiveTo develop a better understanding of nurses’ perspectives and experiences with a bed-exit information system (BES) in an acute care hospital setting. MethodsBES was implemented on 3 wards of a university medical center. Nurses completed 2 online surveys at each time point (P0 and P1) and participated in focus groups before (P0) and after (P1) implementation. Additional patient data were collected. Descriptive statistics summarized the survey results, while content analysis was applied to focus group data. Patient rates and adverse events in both phases were compared using negative binomial models. Reporting of this study adhered to the GRAMMS checklist. ResultsA total of 30 questionnaires were completed at P0 (30/72, 42%) and 24 at P1 (24/71, 33%). Of the participants, 15 completed both questionnaires (complete cases). At P1, 64% (9/14) of participants agreed that their perceived workload and strain in caring for patients with cognitive impairment was reduced by the use of the BES. The adverse event rate per patient per day was reduced by a factor of 0.61 (95% CI 0.393-0.955; P=.03). In addition, 11 nurses participated in 4 focus groups before and after the intervention. Participants found it challenging to operationalize the use of the BES due to the heterogeneity of care settings, but certain behaviors of patients with cognitive impairment were recognized as indicating a need for intervention. Negative experiences included information overload and alarm fatigue, leading to occasional removal of the system. ConclusionsWhile BES provides some support in managing patients with cognitive impairment, its impact remains limited to specific scenarios and does not significantly reduce nurses’ workload or strain. Our findings highlight the need to manage expectations of BES performance to ensure alignment between expected and actual benefits. To improve BES effectiveness and long-term implementation, future research should consider both objective measures of patient care and subjective factors such as nurse experience, structural conditions, and technical specifications. Improving information mechanisms within call systems could help reduce alarm fatigue and increase perceived usefulness. Overall, successful integration of BES in acute care settings will require close collaboration with nursing staff to drive meaningful healthcare innovation and ensure that the technology meets the needs of both patients and nurses. Trial RegistrationGerman Register for Clinical Studies DRKS00021720; https://drks.de/search/de/trial/DRKS00021720https://formative.jmir.org/2025/1/e64444 |
| spellingShingle | Stefan Walzer Isabel Schön Johanna Pfeil Sam Klemm Sven Ziegler Claudia Schmoor Christophe Kunze Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study JMIR Formative Research |
| title | Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study |
| title_full | Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study |
| title_fullStr | Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study |
| title_full_unstemmed | Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study |
| title_short | Nurses’ Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study |
| title_sort | nurses perspectives and experiences of using a bed exit information system in an acute hospital setting mixed methods study |
| url | https://formative.jmir.org/2025/1/e64444 |
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