Each home used nurse call systems and body-worn and environmental
technologies to monitor resident and staff activity. Data collection
included 36 semi-structured interviews with staff, relatives and
residents, and 175 hours of non-participant observation; review of
care records and technology manufacturer literature; Media and
Technology Usage and Attitudes Scale and the System Usability Scale.
Analysis, informed by Normalization Process Theory, focused on
individual and organisational factors influential within successful
In each home, staff training in use of monitoring technologies
appeared to be informal, ad hoc, and based upon assumptions that
staff would find the technologies familiar and simple to use. Staff
lacked full operational knowledge of the technologies, and at times
triggered false alarms. However, it was not clear that increasing
the quantity of formal operational training would have enhanced staff
knowledge and skill. Staff drew upon contextual knowledge of the
homes to work around their lack of operational knowledge of the
technologies. Staff placed a relatively low value upon the use of some
technologies compared to personal delivery of care.
Staff training in the use of monitoring technologies
needs to go beyond simple operational instruction to include a focus
on how the use of the technology aligns with the values of care within
 Yin RK.
Case study research: design and methods
. London: Sage,
Sound levels on a geriatric medicine ward
T.B. Jones, N. Carroll, C. Jerlehag, P.J. Lee.
Royal Liverpool and Broadgreen
University Hospital NHS Trust, Acoustic Research Unit School of
Architecture University of Liverpool
Sound levels within hospital wards may impact
negatively upon patients
recovery. High sound levels lead to poor
speech intelligibility, compromising communication with people with
hearing impairment . High background noise levels are linked to
medication errors . Increased sound levels also disturb sleep and
increase stress levels . Actively reducing ward sound levels can
reduce the incidence and duration of delirium in ITU patients .
The World Health Organisation (WHO) have issued guidelines for
noise levels within hospitals, recommending internal ambient noise
levels, do not exceed LAeq 30 dB (average) and LAFmax 40 dB
(maximum) for wards . We measured sound levels over 24 hours
on a geriatric medicine ward and assessed differences between single
occupancy and multiple occupancy rooms.
Acoustic measurements were undertaken on a geriatric
medicine ward in a university teaching hospital in the UK. Measure-
ments were undertaken in 2 single occupancy rooms, 2 four-bedded
occupancy rooms and 1 six-bedded occupancy room.
Sounds levels consistently exceeded the WHO recommenda-
tions, particularly at night. Therewas no significant difference in sound
levels between single occupancy and multiple occupancy rooms.
Sound levels never fell below 40dB. Noise levels often exceeded 70 dB
with 711 episodes in the single rooms and 726 episodes in the multiple
High sound levels are present within our wards. The
lack of difference between single and multiple occupancy rooms is
pertinent in view of the recent trend towards new hospital buildings
with increased numbers of single occupancy rooms.
 Berglund B, Lindvall T, Schwela DH.
Guidelines for community
. World Health Organization, Geneva,1999. Available online atwww.who.int
 MacKenzie DJ, Galbrun L. Noise levels and noise sources in acute
care hospital wards.
Building Services Engineering Research and
, 2007, 28: 117
 Patel J
The effect of a multipcomponent multidisciplinary
bundle of interventions on sleep and delirium in medical and
surgical intensive care patients.
2014, 69(5): 540
Smart technology as an alternative for physical restraint
, V. Carlassara
, N. Spruytte
, B. Degryse
expertise of the University College VIVES, Bruges,
LUCAS KU Leuven,
Within healthcare, physical restraint is often used and
remains a controversial topic. Exact numbers of use in residential
care homes in Flanders aren
t available, but thanks to research in
2002 (Talloen, Milisen, & Evers, 2002) an estimation can be made. In
the past years many efforts have been made to reduce the use of
physical restraint, such as using less profound alternatives. However,
it can be seen that physical restraint remains to be the preferred
method by some care professionals. The use of physical restraint
can have a negative impact on the wellbeing of patients, so it is
advisable to find a more proper solution and change the current way
The STAFF-project investigates whether smart tech-
nology, more specific bed-exit alarm systems, can be an alternative for
physical restraint. A bed-exit alarm system sends out an alarm when
someone leaves his bed, attempts to leave his bed or hasn
t returned to
his bed on time. This project consists of 2 parts, (1) a survey that
examines the vision of care professionals on physical restraints
and smart technology as an alternative, and (2) an intervention
study were 8 different bed-exit alarm systems are implemented in 9
Flemish residential care homes. Every facility gets to test 2 different
technologies for a period of 6 months. After 3 month they had to move
the technology to another resident in the care facility.
The main goal of the intervention study is to examine if bed-exit alarm
systems have an impact on the resident, the care professional and care
flow. Quantitative and qualitative data is gathered through (1) focus
group interviews with care professionals (mainly nightshift) and in-
depth interviews with the resident (whenever possible), and (2)
normalized questionnaires. Through pretest-posttest design these
questionnaires monitor whether bed-exit alarm systems influence:
the quality of life (QUALIDEM), everyday activity (Katz-scale) and
unrest (CMAI) of the elderly.
the acceptancy of technology (TRI), the vision against physical
restraint (MAQ) and the use of smart technology as an alternative by
There are many preconditions that influence the successful
implementation and use of technology in residential care homes.
s why tips & trics are collected based on the experiences of 9
residential care homes with 8 different bed-exit alarm systems as an
alternative for physical restraint. First of all, it is very important to
involve the care professional in the choice of an alternative form,
because eventually they are the one who will be working with it and
will have to rely on its proper functioning. The success of technology
implementation depends also on the ease of connecting the
technology with the existing infrastructure of the care facility. Most
of the care facilities have an outmoded nurse call systemwhich cannot
connect with an extra standalone system, such as a bed-exit alarm
system. Furthermore, training is necessary to convince care givers to
work with the technology. Not only to get to know the technology but
also to build up enough self-confidence to work and relay on it. If they
do not support the choice for a bed-exit alarm system, the technology
will not be used in a proper way.
Bed-exit alarm systems can be an alternative for physical
restraint. This is not so much due to the technology itself, but due to
the autonomy that is given back to the resident. Each form of restraint
is choosing between a certain degree of autonomy and safety of the
person. A personal approach is important to find the best solution that
meets those individual needs. Finally, involve the care professional in
the choice of an alternative form, because eventually they are the one
Poster presentations / European Geriatric Medicine 7S1 (2016) S29