Highlights
- •Time pressure is a barrier for the day of discharge teaching.
- •ePED is a tool for an engaging structured discharge conversation with parents.
- •RE-AIM method used to evaluate the ePED's reach, adoption and implementation.
- •Adoption rate was high indicating feasibility of the ePED
- •Preparation of nurses needed to help family think forward to transition home.
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.
Keywords
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References
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Article info
Publication history
Published online: June 09, 2020
Accepted:
May 28,
2020
Received in revised form:
May 27,
2020
Received:
December 22,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
