Transition from Paper to Electronic Nursing Documentation in Residential Aged Care: an Actor Network Theory Analysis

Lemai Nguyen, Lachlan Bakewell, Nilmini Wickramasinghe, Peter Haddad, Imran Muhammad, Hoda Moghimi, David Wilde, Bernice Redley, Julie Considine, Mari Botti


Objectives: To examine the role of technology when introduced into the specific setting of residential aged care and then analyse the associated changes to this complex socio-technical network of human and technology actors on the introduction of this technology using the rich lens of Actor Network Theory.

Methods: An exploratory qualitative single case study was conducted. The specific focus being the implementation of a nursing information system in an aged care context, i.e. the transition from paper-based nursing documentation to electronic nursing documentation. A series of 19 semi structured interviews with facility managers, nursing coordinators, and the nursing and care staff were conducted. The collected data were analysed using standard qualitative techniques such as thematic analysis and a priori themes were developed from the application of Actor Network Theory.

Results: A priori themes coupled with emergent themes served to highlight the impact of a disruptive technology solution into a complex context.

Conclusion: An Actor Network Theory analysis enables a rich theoretical lens to be used to examine the introduction of a disruptive technology into a complex context.  On such examination critical success factors were identified as well as key barriers. Moreover, people issues were found to be central to the success of such a solution.


Electronic nursing documentation; Technology implementation; Actor Network Theory

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