Temporalities of care management software in residential aged care

Care management software are implemented in nursing homes to enhance traceability, communication, and coordination for care workers. These software, available on computers and increasingly on digital tablets, can be utilized according to two temporalities: "in real time," at the point-of-care just before or after administering treatment, and "delayed," following a set of treatments. There is a need to understand the real-world usage of care management software and their effects on care workers, considering these two temporalities. The objectives of this qualitative study are: (1) to explore how caregivers and nurses in nursing homes utilize care management software over time (2) to analyze how each temporality affects perceived work intensity, autonomy, meaning, and collective work; and (3) to identify the strategies employed by care workers to manage these temporalities. The results indicate that four caregivers and one nurse consistently delayed the use of the care management software throughout their shifts, while six caregivers and three nurses combined both "real-time" and "delayed" use. During real-time use, workers reported a felling of reduced cognitive load and greater autonomy. However, they also faced time pressure, interruptions in nursing activities, and increased complexity from frequent software use on digital tablets. Delayed use was associated with less time pressure and the possibility of collective use, but it required more memorization and reduced autonomy due to limited computer availability. <br/>
The ability to choose between temporalities enables care workers to navigate the temporal, material, and organizational challenges encountered during care activities. They seek to maximize the benefits of each temporality while minimizing the negative effects on work intensity, autonomy, meaning, and collective work. The discussion addresses opportunities and strategies to enhance the material, temporal, and organizational conditions that support each temporality of care management software use. In particular, real-time use may demand additional support from nursing home stakeholders.