Table 3.

Results of ethnographic observations analysed by UTAUT-categories.

UTAUT categories	(Observed) performance	(Observed) effort	(Observed) social influence	(Observed) facilitating conditions
	Note: The colour coding in the fields indicates whether the corresponding factor bundle is predominantly positive (green), negative (red) ambivalent (yellow) or has no influence on technology acceptance (not filled).
Mobilisation mattress	Decision for using based on risk assessment and professional intuition and depends on: Diagnosis, especially postoperative patients with pain during positioning Time of the day (only in the night or 24 h) General patient condition (few proper motion, high risk for pressure ulcer) Perceived overall reduction of pressure ulcer frequency from nurses perspective	Reliable system, performs work “in background” that relieved time resources for other tasks Perceived reduction of back pain for nurses Became part of routine practice in course of research project	Collaboration with colleagues during decision making, actual use is done in individual work routine Patients usually get informed by nurses on function of the mattress Patients report better sleep, few patients report form of “motion sickness”, most get used to the sensation. Nurses perceive improvement of relationship to patients due to better sleep Substitution or reduction of social interaction not observed	High demand by nurses led to an increase in stock to sufficient number of systems Upper body elevation up to 50 degree is optimal (former 30 degree version also tested; led to additional problems) No lack of competences to use system observed, calibration is perceived to be simple
Fall prevention system	Use in patients prone to falls due to individual medical condition (e. G. dementia) Mixed reports on whether technology actually reduces falls Nurses report false alarms and see technology as unreliable Use even when it is unreliable	Dissatisfaction based on time-consuming installation, false alarms and frequent defects that require external repair	Preparation of the use of the systems (installation in the patient bed) in teams, especially in the night shift Team work performed while users take care of small repairs of malfunctioning systems in teams No change in social interaction between nursing professional and patients due to technology observed	Resource scarcity depends on dysfunctional systems Nurses report false alarms or not activating alarms in case of real bed-exit attempt Insecurity about correct installation and use of the system even after manufacturer trainings
Audio-haptic sound pillow	Mainly used for patients with agitation, challenging behavior and pain Positive response from patients (calming, activity/interaction with the technology) Patients lose interest after few days based on monotony of the melody and deactivation of the technology after inactivity Use during night times limited to patients in single bed room	Used to increase patient adherence to nursing intervention Used as an additional means of calming patients down Nurses have to reactivate pillow due to automatic stand-by Technology allows nurses to leave patients unattended for short periods of time	No relevant team work or communication observed Nurses try to present device in an interesting way for patients If patients will not respond to verbal presentation, they present it non-verbally Some patients are not interested, others are highly interested	No resource problem observed The cover can be disinfected with wipe disinfection Every new employee receives a short introduction into the technology, no competence related problems observed
Special projector	Patient-dependent decision-making process made by nurses (who, where, when, which module?) Positive response from patients Used in patients with agitation, challenging behavior Outcome depends on desired goal: Calming modules at night when patients need to rest Activating methods during the day with agitated patients	Ease of nursing care, especially for time and effort to be spent on patients with challenging behaviors Nurses are satisfied with use and the outcomes Nurses perceive (de-) installation and use as easy, technology became part of routine practice	No relevant team work or communication observed Nurses perceive technology to have a positive effect on nurse-patient relationship Some patients’ reaction is negative on particular modules, nurses have to respond to patient reaction and chose suiting module Fellow patients could perceive technology (sound, light) as annoying	No resource problem observed Technology offers a variety of modules with different visualizations, sounds and operating modes Every new employee receives a short introduction into the technology, no competence related problems observed
Interactive therapy ball	Primary use for patients with mild states of confusion or dementia, but who are still oriented Supposed to lead to an improvement in the general mental state of patients; however, the technology has been used too rarely in practice, so that no observations could be made on effects	Nurses see positive and easing benefits of the technology, but cannot use it in everyday practice (familiarization and use is too time-consuming). No sustained use was observed, tested on few occasions, especially in educational situations	Few uses are observed in training situations, trainees have more time to interact with patients Potential for positive influence on nurse-patient relationship is suspected by nurses, but work conditions prevent regular use	Time is a limiting factor Functional spectrum is complex and menu navigation needs time for using Nurses workload is too high for using the technology Operation via remote control, nurses wish for voice control
Patient-Nurse communication app	Use depends on nurses’ assessment of whether patients can operate an app Used to remind nurses about upcoming tasks, events or to prioritize patient requests Use of the technology can reduce redundant path and/or reduce noise from acoustic nurses call sign However, nurses doubt performance for work after few weeks of use Empirically app is mostly used for nursing care (not service) related requests	Nurses are concerned about what app suggests to patients about nature of nursing care (nursing care as a service instead of a health care profession) Some nurses refuse to work with additional (smart) phone Doubt that redundant path reduction has a relevant ease in daily walking distance Nurses criticise that nursing care is more than the reaction to articulated patient wishes but an interaction that allows to grasp patients’ needs	Successful use of app requires continued use of app between shifts, which is rarely observed Ambivalent reaction by patients that used app: most find it helpful and easy to use, some do not see the benefit for patients (but recognise benefits for nurses) Faster and more transparent communication between nurses and patients was observed Nurses expect patients to use app primarily for nursing (not service) related requests	A smartphone for each section of the ward is provided for using the tec. The patients have to use their own smartphone, download app and register via specific code High technology competence required for patients and nurses, merely fraction of patients on ward are suitable
Tracking system	[Contrary to initial nurses intention to use the technology, tracking turned out to be not helpful] Nurses report that when they are searching for a product, they ask colleagues or have seen it during their daily activities No effects on patients observed	Low satisfaction due to lack of relevance No workplace integration into routine practice (although full technical implementation), because no practical relevance for work Nurses suggest that technology would be helpful if it could be applied to the entire clinic	Communication with other colleagues about where (technological) products are makes the technology useless No effects were observed regarding the social interaction and substitution with patients	Wi-Fi and tablet to use system was installed and is functioning, no technical issues are observed The system could find products which are provided with a Bluetooth-tracker