A Nurse-Led Multimedia Intervention to Increase Patient Participation in Recovery After Knee Arthroplasty: Hybrid Type II Implementation Study (Preprint)

Abstract

BACKGROUND Advances in digital technology and the use of multimedia platforms to deliver information provide clinicians with a unique opportunity to develop innovative ways to consistently provide high quality, accessible, evidence-based information to support patient participation. Introducing new technologies into everyday acute care clinical practice can be difficult. OBJECTIVE This paper provides a description of an implementation strategy and subsequent evaluation undertaken to examine the contextual factors important to the successful adoption of new technology by nurses in the context of acute postoperative care. METHODS Implementation of the intervention and process evaluation were undertaken in three phases: Phase-1: pre-implementation stakeholder engagement, identification of barriers and enablers to implementation. Phase-2: supported implementation of the intervention and Phase-3: evaluation of uptake of the intervention in clinical practice. RESULTS Outcomes of implementation of the multimedia intervention in the context of acute postoperative care were positive. A total of 104 patients were in the intervention group, of these 97 (93%) patients were interviewed on Day 3 to evaluate usability and feasibility. Patients found the program easy to use, had high satisfaction with the content and the program required minimal time for orientation. Collaboration with nurses and patients prior to and during implementation to identify potential barriers to successful implementation of the intervention was essential to develop timely strategies to overcome these. To ensure end-user engagement, careful consideration was given to nurses’ views on who were responsible for facilitating this intervention. CONCLUSIONS The findings provide evidence that the structured implementation of the multimedia intervention was robust and successful in terms of patient participant recruitment and application, however, it was difficult to assess the level of engagement by nurse clinicians with the program.