Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University Medical Center, Chicago, Illinois.
Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Respir Care. 2019 Apr;64(4):416-424. doi: 10.4187/respcare.06428. Epub 2019 Jan 22.
The modified early warning score (MEWS) is used to detect early clinical deterioration and to escalate care as needed. Respiratory therapists (RTs) usually do not use the MEWS even when it is implemented as a default in the electronic health record system. This study explored whether the technology acceptance model could predict the intentions of RTs to use the MEWS.
A validated survey that uses a pretest/posttest design was used to determine the effect of an educational intervention (lecture and interactive small group session) on RTs' MEWS knowledge. We also measured key determinants of the intention by RTs to use the MEWS based on the constructs of the technology acceptance model. The survey was distributed to 75 RTs employed at a Midwestern academic medical center.
There was a 61% survey response rate. Statistical analysis of the survey data demonstrated that the educational intervention increased the MEWS knowledge score from 2.0 before education to 4.0 after education ( < .001). Moreover, there was a statistically significant increase in the behavioral intention score, from 3.0 before education to 4.0 after education ( < .001). Partial least squares structural equation modeling revealed that MEWS knowledge influenced perceived ease of use, which influenced attitude, which influenced behavioral intention.
Numerous studies have demonstrated that a change in behavioral intention is a good predictor of change in behavior. The increase in the RTs' knowledge, attitude, and behavioral intention scores after MEWS education indicated that these RTs may be more inclined to use the MEWS if they were educated about its clinical relevance and if their attitude toward using it were favorable. Analysis of the study results also indicated that the technology acceptance model could serve as a framework to guide respiratory care managers in the development of strategies to successfully implement new systems or processes that are intended to be used by RTs.
改良早期预警评分（MEWS）用于检测早期临床恶化，并在需要时升级护理。呼吸治疗师（RT）即使在电子病历系统中默认使用 MEWS 时，也通常不使用它。本研究探讨了技术接受模型是否可以预测 RT 使用 MEWS 的意愿。
使用预测试/后测试设计的验证性调查用于确定教育干预（讲座和互动小组会议）对 RT 对 MEWS 知识的影响。我们还根据技术接受模型的结构，测量了 RT 使用 MEWS 的意愿的关键决定因素。该调查分发给中西部学术医疗中心的 75 名 RT。
调查的回应率为 61%。对调查数据的统计分析表明，教育干预使 MEWS 知识得分从教育前的 2.0 提高到教育后的 4.0（<0.001）。此外，行为意愿得分从教育前的 3.0 提高到教育后的 4.0，具有统计学意义（<0.001）。偏最小二乘结构方程模型显示，MEWS 知识影响感知易用性，进而影响态度，进而影响行为意愿。
许多研究表明，行为意愿的改变是行为改变的良好预测指标。在 MEWS 教育后，RT 的知识、态度和行为意愿得分增加，这表明如果教育他们有关 MEWS 的临床相关性，并对使用 MEWS 的态度有利，这些 RT 可能更倾向于使用 MEWS。对研究结果的分析还表明，技术接受模型可以作为指导呼吸治疗管理人员制定策略的框架，以成功实施旨在由 RT 使用的新系统或流程。
