Delivery of high-quality continence care to of continuing residents remains challenging.  Check and change regimens may lead to inappropriate pad checks and changes & sleep disruption. The application of technology devices, like urine saturation sensors in pads, may aid appropriate pad use and ensure timely change, but there are few data on the utility of such devices. As part of a clinical trial, this qualitative substudy examined staff impressions of the use of a digital health device for residents with urine incontinence.

Staff who were trained on the digital health technology and used it during the study intervention were invited to participate in a qualitative interview to share their experiences. Written informed consent was obtained. Interviews were conducted using a semi-structured interview which assessed initial impressions of the device, training offered, experiences and challenges in using the device, and benefits and limitations of the device in delivery of continence care. Interviews were conducted over Zoom or in person. Each was recorded, transcribed and deidentified for analysis. Data were analysed using a conventional content analysis approach (1). Two researchers independently coded two transcripts to develop a coding framework, then met to compare codes and develop the initial coding framework. Remaining transcripts were coded by a single researcher with joint review of any new codes. Codes were collapsed into categories and then into themes.

Data saturation (2) occurred after 14 interviews. All participants were female. Interviews lasted 8.4-50.1(mean, 24.7) minutes. Analysis resulted in 111 codes, collapsed into 17 categories and 4 themes: 1.Staff and Facility Factors reflected staff’s attitudes towards the sensor and its perceived utility. Participants were excited to use the system and liked what the sensor offered. Younger staff were more open to its use. The system allowed managers to hold staff accountable and to adjust work routines to provide care to residents. Some staff didn't like how the system made them feel like they were being tracked 2. Resource considerations: The system increased workload as residents needed changing outside of established routine. Changing and replacing batteries in the system added another task. Some felt that the sensor saved time as pads were not changed unnecessarily. More staff were required for the system to work well and be implemented in their facilities. The system may save on continence products. 3. Sensor Characteristics: Participants described using the device as easy to use. They were concerned with equipment failure impairing its utility. 4. Resident Needs and Quality of Life: Participants were happy about not making residents sit in a saturated brief. Timely response helped improve skin health The device helped unnecessary sleep disruption. This improved residents’ quality of sleep.

Overall, staff felt the device had more advantages than disadvantages. They found utility in care delivery and felt that use improved resident outcomes but required change in work practices for successful implementation.

The application of a digital technology device was felt to aid appropriate pad use and ensure timely change for residents of continuing care, potentially improving resdient quality of life.

Qual Health Res [Internet]. 2005 Nov;15(9):1277-88
Qualitative Inquiry and Research Design Choosing among Five Approaches. 4th Edition, SAGE Publications, Inc., Thousand Oaks, 2018.