Background: Artificial intelligence (AI) is increasingly introduced into healthcare, promising improved efficiency and clinical decision-making. While research has mainly focused on AI in hospital settings and physician perspectives, less is known about how AI may challenge the values that guide nursing practices. This study explores nurses’ perceptions of wound care in municipal home healthcare and the opportunities and challenges with the integration of AI technologies into their practices.

Methods: An exploratory qualitative study using semi-structured interviews was conducted with 14 registered nurses from two municipalities in Sweden. Participants were recruited through purposive sampling, and data were collected through individual interviews, either in person or via video call. Interviews were transcribed verbatim and analyzed inductively, inspired by the Gioia methodology. This approach allowed themes to emerge from the data while maintaining close alignment with participants’ perspectives. In a subsequent phase, the data were interpreted through the lens of Mol’s Logic of Care to deepen understanding of the relational, embodied, and adaptive nature of wound care. Ethical approval was obtained, and the study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Results: Three interconnected dimensions emerged from the data: relational, embodied, and adaptive practices. Nurses emphasized the importance of relational work in wound care, highlighting the trust and continuity necessary for effective wound care, which AI-driven automation might overlook. Embodied practices, such as sensory engagement through touch, sight, and smell, were central to wound care, raising nurses’ concerns about AI’s ability to replicate these nuanced judgments. Adaptive practices, including improvisation and situational awareness in non-standardized home environments, were presented as challenges for AI integration, as existing digital systems were perceived as rigid and often increased administrative burdens rather than streamlining care.

Conclusions: Home healthcare nurses’ perspectives highlight the complex interplay between technology and caregiving. While AI could support documentation and diagnostic processes, its current limitations in relational, sensory, and adaptive aspects raised the nurses’ concerns about its suitability for wound care in home settings. Successful AI integration should account for the realities of nursing practice, ensuring that technological tools enhance the embodied, relational, and adaptive dimensions of wound care. Applying Mol’s Logic of Care helps illuminate how good care emerges through ongoing, situated practices that resist full automation. Future research could further explore how AI aligns with professional nursing values and decision-making in real-world care settings.

 © The Author(s) 2025.

Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. © 2024 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

This study delves into the landscape of eHealth intervention implementation in home healthcare and primary healthcare centers in Sweden, with a specific emphasis on unraveling the perspectives and insights of nurses. Anchored in the relational character of data, where rationality hinges upon data creation and interpretation (Winthereik, 2023), the research endeavors to untangle the complexities of data utilization in healthcare settings. The study delves into the concept of data within the realm of nursing work, probing whether the aspiration for data-informed practices resonates with nurses’ perspectives. The research scrutinizes the nuanced realities of technology adoption by nurses, thereby contributing to a profound understanding of their professional practices.Semistructured interviews were conducted with 20 nurses within two municipalities in Sweden, providing a qualitative exploration of their experiences with eHealth interventions.

Theoretically, the presentation develops literature on nursing work and the relation between knowledge and professionalism using Mol’s concept of ‘good care’ as a local and situation-specific practice (Mol, 2006). Mol’s framework underscores the necessity for sensitivity and creative calibration in nursing, spotlighting the dynamic nature of professional practice where elements are finely tuned until they harmonize within a given situation.

The presentation attempts to yield practical insights into the challenges and opportunities entwined with the integration of eHealth interventions into nursing practice. By exploring the multifaceted realities of technology use in healthcare, the presentation contributes valuable perspectives to the ongoing development of data-informed nursing care.

References:

Mol, A. (2006). Proving or Improving: On Health Care Research as a Form of Self-Reflection. Qualitative Health Research, 16(3), 405–414.

Winthereik, B. R. (2023). Data as Relation: Ontological Trouble in the Data-Driven Public Administration. Computer Supported Cooperative Work.

Background

The implementation of e-health is transforming healthcare. The acknowledged benefits of digitalization are quality improvement, patient empowerment, and increased efficiency. The mobility of e-health makes it especially suitable for home healthcare. eMar is a common e-health technology used in Swedish home healthcare. Decisions about technology design are governed by developers’ perceptions of intended users. These perceptions can be identified in the description and promotion of a specific product.

Purpose

The purpose of the presentation is to contribute to increased knowledge about the values entailed in a specific eMar used in Swedish home healthcare, and furthermore to discuss how these values conform with existing national missions such as people-centered care.

Method

Information consisting of sales materials about a specific eMar used in several Swedish municipalities has been analyzed through critical discourse analysis to visualize values embedded in the eMar.

Findings

Preliminary results show that the provider of the specific eMar describes care in terms borrowed from the industrial sector, such as shift changes and production of care. Good and safe care is defined as the right person receiving the right medicine at the right time. Furthermore, the app is advertised as a tool for monitoring assuming that the performance of tasks can be influenced through the remote control of the employee. The eMar is described as representing new and modern technologies that are expected to raise the status of healthcare professions and facilitate the recruitment of employees.

Svensk primärvård står inför stora utmaningar med en åldrande befolkning och ett ökat antal personer som vårdas i hemmet (Landers et al., 2016). Digital teknik implementeras med förhoppning om att förbättra kommunikationen mellan vårdpersonal och underlätta möjligheterna till egenvård och tillgänglighet för patienter (Socialstyrelsen, 2021). Tidigare studier visar att användningen av digital teknik kan förändra det professionella landskapet (Petersson, 2020) och påverka arbetsmiljö och arbetets innehåll (Ertner, 2019). Trots att teknik som implementeras inom vården bör vara anpassad till hälso- och sjukvårdspersonalens arbete och värderingar (Palmer et al., 2019; Reed et al., 2019) är sjuksköterskor sällan involverade i beslut kring utformning eller implementering av ny teknik (von Gerich et al., 2022). Det behövs mer kunskap om hur digitaliseringen kan ske i samproduktion med sjuksköterskor och utformas så att en god arbetsmiljö bibehålls.

Presentationen syftar till att beskriva sjuksköterskors arbete och arbetsmiljö inom hemsjukvården och hur dessa kunskaper kan användas vid utvecklingen och implementeringen av framtida digital teknik.

Individuella semi-strukturerade intervjuer har genomförts med 20 sjuksköterskor som arbetar på vårdcentral och inom hemsjukvård i två halländska kommuner. Intervjuerna har analyserats genom kvalitativ innehållsanalys (Hsieh & Shannon, 2005). Implementeringsteoretiska ramverk används för att undersöka hur kunskapen kan inkorporeras vid innovation och implementering av digitala tekniker inom vårdverksamheter (Nilsen, 2015).

Preliminära resultat kommer att presenteras vid konferensen.

Referenser

Ertner, S. M. (2019). Enchanting, evoking, and affecting: the invisible work of technology implementation in homecare. Nordic Journal of Working Life Studies, 9(S5), 33-47.

Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative health research, 15(9), 1277-1288.

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262-278.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10(1), 53-53.

Palmer, V. J., Weavell, W., Callander, R., Piper, D., Richard, L., Maher, L., Boyd, H., Herrman, H., Furler, J., & Gunn, J. (2019). The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement. Medical humanities, 45(3), 247-257.

Petersson, L. (2020). Paving the way for transparency: How eHealth technology can change boundaries in healthcare Lund University].

Reed, J. E., Howe, C., Doyle, C., & Bell, D. (2019). Successful healthcare improvements from translating evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research. International journal for quality in health care, 31(3), 238-244.

Socialstyrelsen. (2021). E-hälsa och välfärdsteknik i kommunerna 2021. Uppföljning av den digitala utvecklingen i socialtjänsten och den kommunala hälso-och sjukvården.

von Gerich, H., Moen, H., Block, L. J., Chu, C. H., DeForest, H., Hobensack, M., Michalowski, M., Mitchell, J., Nibber, R., & Olalia, M. A. (2022). Artificial Intelligence-based technologies in nursing: A scoping literature review of the evidence. International Journal of Nursing Studies, 127, 104153.

Increased use of digital technologies in healthcare offers healthcare professionals multiple ways to perform tasks and interact with patients and colleagues. We used the JDCS model to identify employee´s well-being in relation to the use of an eMar. The analysis indicated that the specific technology influenced the work environment for registered nurses and nursing assistants in different ways.

Background:eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals.

Objective: The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality.

Methods: This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz.

Results: Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses’ superior position. The experience of the eMAR was regarded as transitioning the nurses’ professional role—away from the point of care and toward more administration—and further strengthened the way of managing work through delegation to health care assistants.

Conclusions: Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals’ work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels. ©Sara Karnehed, Lena-Karin Erlandsson, Margaretha Norell Pejner.