Norah L Johnson1, Stacee Lerret2, Carol G Klingbeil3, Michele Polfuss4, Cori Gibson5, Karen Gralton6, Mauricio Garnier-Villarreal7, S Iqbal Ahamed8, Adib Riddhiman9, Rachel Unteutsch10, Louis Pawela11, Rosemary White-Traut12, Kathy Sawin13, Marianne Weiss14. 1. College of Nursing, Marquette University, Milwaukee, WI, United States of America; Children's Hospital of Wisconsin, Milwaukee, WI, United States of America. Electronic address: norah.johnson@marquette.edu. 2. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America; Medical College of Wisconsin, Milwaukee, WI, United States of America. Electronic address: slerret@mcw.edu. 3. College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America. Electronic address: klingbei@uwm.edu. 4. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America; College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America. Electronic address: MPolfuss@chw.org. 5. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America. Electronic address: CGibson@chw.org. 6. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America. Electronic address: KGralton@chw.org. 7. College of Nursing, Marquette University, Milwaukee, WI, United States of America. Electronic address: mauricio.garniervillarreal@marquette.edu. 8. College of Nursing, Marquette University, Milwaukee, WI, United States of America. Electronic address: sheikh.ahamed@marquette.edu. 9. College of Nursing, Marquette University, Milwaukee, WI, United States of America. Electronic address: riddhiman.adib@marquette.edu. 10. Medical College of Wisconsin, Milwaukee, WI, United States of America. Electronic address: runteutsch@mcw.edu. 11. Medical College of Wisconsin, Milwaukee, WI, United States of America. Electronic address: lpawela@mcw.edu. 12. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America. Electronic address: RWhite-Traut@chw.org. 13. Children's Hospital of Wisconsin, Milwaukee, WI, United States of America; College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America. Electronic address: KSawin@chw.org. 14. College of Nursing, Marquette University, Milwaukee, WI, United States of America. Electronic address: marianne.weiss@marquette.edu.
Abstract
PURPOSE: This paper describes the evaluation of the implementation of an innovative teaching method, the "Engaging Parents in Education for Discharge" (ePED) iPad application (app), at a pediatric hospital. DESIGN AND METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation. Three of the five RE-AIM elements are addressed in this study: Reach, Adoption, and Implementation. RESULTS: The Reach of the ePED was 245 of 1015 (24.2%) patient discharges. The Adoption rate was 211 of 245 (86%) patients discharged in the five months' study period. High levels of fidelity (89.3%) to Implementation of the ePED were attained: the Signs and Symptoms domain had the highest (93%) and Thinking Forward about Family Adjustment screen had the lowest fidelity (83.3%). Nurse themes explained implementation fidelity: "It takes longer", and "Forgot to do it." CONCLUSIONS: The ePED app operationalized how to have an engaging structured discharge conversation with parents. While the Reach of the ePED app was low under the study conditions, the adoption rate was positive. Nurses were able to integrate a theory-driven practice change into their daily routine when using the ePED app. IMPLICATIONS FOR PRACTICE: The rates of adoption and implementation fidelity support the feasibility of future hospital wide implementation to improve patient and family healthcare experience. Attention to training of new content and the interactive conversation approach will be needed to fully leverage the value of the ePED app. Future studies are needed to evaluate the maintenance of the ePED app.
PURPOSE: This paper describes the evaluation of the implementation of an innovative teaching method, the "Engaging Parents in Education for Discharge" (ePED) iPad application (app), at a pediatric hospital. DESIGN AND METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation. Three of the five RE-AIM elements are addressed in this study: Reach, Adoption, and Implementation. RESULTS: The Reach of the ePED was 245 of 1015 (24.2%) patient discharges. The Adoption rate was 211 of 245 (86%) patients discharged in the five months' study period. High levels of fidelity (89.3%) to Implementation of the ePED were attained: the Signs and Symptoms domain had the highest (93%) and Thinking Forward about Family Adjustment screen had the lowest fidelity (83.3%). Nurse themes explained implementation fidelity: "It takes longer", and "Forgot to do it." CONCLUSIONS: The ePED app operationalized how to have an engaging structured discharge conversation with parents. While the Reach of the ePED app was low under the study conditions, the adoption rate was positive. Nurses were able to integrate a theory-driven practice change into their daily routine when using the ePED app. IMPLICATIONS FOR PRACTICE: The rates of adoption and implementation fidelity support the feasibility of future hospital wide implementation to improve patient and family healthcare experience. Attention to training of new content and the interactive conversation approach will be needed to fully leverage the value of the ePED app. Future studies are needed to evaluate the maintenance of the ePED app.