Author Identifier
Margaret Dayo Adejumo: http://orcid.org/0000-0003-4730-4258
Date of Award
2026
Keywords
Home care, workstation on wheels, innovation, quality and safety
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Doctor of Philosophy (Integrated)
School
School of Nursing and Midwifery
First Supervisor
Davina Porock
Second Supervisor
Melanie Baker
Third Supervisor
Wai Hang Kwok
Abstract
The global shift toward home-based care has underscored persistent barriers to delivering safe, efficient, and high-quality services outside institutional settings. Unlike hospitals, home environments lack standardised facilities, adjustable equipment, and infection control infrastructure, exposing nurses to occupational risks and compromising patient outcomes. These challenges, compounded by workforce pressures and limited organisational support, highlight the urgent need for practice-informed innovations to support community nursing.
This thesis addresses that need by introducing HoMedCart, a nurse-led innovation that adapts the functionality of hospital-based Workstations-on-Wheels (WoWs) for home care. Grounded in clinical experience and empirical inquiry, the research employs a pragmatic methodology that integrates traditional research methods with innovation processes. A scoping review of international literature identified systemic barriers to quality and safety in domiciliary care. Qualitative interviews with Australian community nurses provided detailed accounts of how these barriers manifest in practice, revealing environmental unpredictability, ergonomic strain, and insufficient context-specific training. Finally, a proof-of-concept study engaged nurses with photorealistic renderings of the proposed HoMedCart to explore perceptions of feasibility, usability, and adoption.
Data were analysed using reflexive thematic analysis, enabling a nuanced understanding of practice realities while acknowledging researcher reflexivity. The development process was guided by the Technology Readiness Level (TRL) framework, which provides a structured pathway for staged innovation. The study concludes at TRL 3, having established the conceptual and practical feasibility of the HoMedCart while setting the foundation for future prototype development and testing.
The findings reframe barriers in home care as structural rather than individual, showing that risks to safety arise from systemic and environmental factors rather than from practitioner behaviour. The research demonstrates the value of applying structured innovation frameworks such as the TRL model to nursing, providing a transparent pathway for developing and testing new ideas. It also establishes design, co-production, and visualisation as legitimate methods for generating knowledge in nursing research. Finally, the proof-of concept work highlights the potential of the HoMedCart to improve infection control, workflow, and ergonomics in home care, while identifying the organisational and policy conditions that must be in place for adoption. This thesis positions nurses not only as providers of care but as innovators capable of shaping safer and more effective models of healthcare delivery.
Access Note
Access to this thesis is embargoed until 25th April 2030
Recommended Citation
Adejumo, M. D. (2026). Developing Workstation-on-Wheels in home care: An innovative approach for promoting high quality safe care in home settings. Edith Cowan University. https://doi.org/10.25958/75sn-vn96