TY  - JOUR
AU  - Walzer, Stefan
AU  - Schön, Isabel
AU  - Pfeil, Johanna
AU  - Merz, Nicola
AU  - Marx, Helga
AU  - Ziegler, Sven
AU  - Kunze, Christophe
PY  - 2025
DA  - 2025/3/4
TI  - Experiences With an In-Bed Real-Time Motion Monitoring System on a Geriatric Ward: Mixed Methods Study
JO  - JMIR Form Res
SP  - e63572
VL  - 9
KW  - nurses
KW  - geriatric patients
KW  - cognitive impairment
KW  - technology
KW  - fall prevention
KW  - hospital
KW  - mixed methods
KW  - patient
KW  - learning process
KW  - assessment
KW  - autonomy
KW  - impairment
KW  - real-time motion
KW  - university
KW  - geriatric ward
KW  - survey
KW  - anxiety
KW  - willingness
KW  - patient privacy
KW  - effectiveness
KW  - monitoring system
KW  - health care practice
AB  - Background: Older adults now make up about two-thirds of hospital admissions, with up to 50% experiencing cognitive impairments such as dementia. These patients often struggle with adherence to care plans and maintaining regular day or night cycles, presenting challenges for nurses. Hospitals are typically unprepared to manage this patient population, resulting in increased nurse workload and challenges like managing motor agitation, which can lead to falls or accidental removal of medical devices. Objective: This study aimed to (1) assess how an in-bed real-time motion monitoring system (IRMS) impacts nurses’ perceptions of physical and mental stress, (2) evaluate the IRMS’s effect on the care process, (3) explore ethical implications like patient autonomy and privacy, and (4) understand how nurses acquire knowledge about the technology and how this affects their assessment of the IRMS. Methods: The IRMS, which provides real-time motion monitoring and bed edge or exit information, was implemented in the geriatric ward of a university medical center. The study followed a monocentric, explorative evaluation design using a mixed methods approach. It lasted 24 weeks and had two phases. In Phase 0 (6 weeks), patients received standard care. In Phase 1 (18 weeks), the IRMS was introduced. Initial data were gathered through focus groups and participant observations during manufacturer training sessions. At the end of the intervention, a survey, a second focus group, and an interview were conducted to capture nurses’ experiences. The study follows the Good Reporting of a Mixed Method Study (GRAMMS) checklist for reporting. Results: Initial training sessions with 12 participants (10 nurses and 2 physiotherapists) showed varying levels of engagement, with the second session demonstrating more optimism and interprofessional collaboration. A total of 10 questionnaires were completed (10/21, 48%). Survey results showed that 80% (8/10) of nurses found the IRMS valuable for assessing the quality of work, and 90% (9/10) were willing to continue using it. The system was regarded as reliable for monitoring bed edge and exit events. Usability was positively rated, with minimal concerns about documentation burden. Focus group discussions (n=3 per session) indicated that nurses viewed the system as reliable and appreciated its role in reducing anxiety related to fall prevention. However, concerns about patient privacy and monitoring were raised. Nurses expressed a willingness to continue using the IRMS but reaffirmed their ability to care for patients without it. Conclusions: Nurses had a generally positive attitude toward the IRMS, recognizing its benefits, particularly for nighttime monitoring. Although its effectiveness in preventing falls remains inconclusive, the system helps reduce nurses’ fear of falls and enhances their responsiveness. The study highlights the broader impact of the IRMS beyond fall prevention and stresses the importance of thoughtful integration into health care practice. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2025/1/e63572
UR  - https://doi.org/10.2196/63572
UR  - http://www.ncbi.nlm.nih.gov/pubmed/40053780
DO  - 10.2196/63572
ID  - info:doi/10.2196/63572
ER  -