Authors (including presenting author) :
Pun KL(1), Yuen SY(1), Chan YY(2), Wong CW(3), Ma KW(4), Ho WF(5), Au CL(6), Kan WS(6), Wong KW(1)
Affiliation :
(1) Nursing Services Division, Tung Wah Eastern Hospital (TWEH)
(2) Department of Medicine & Rehabilitation, TWEH
(3) Nursing Services Division, Ruttonjee & Tang Shiu Kin Hospitals (RTSKH)
(4) Nursing Services Division, Wong Chuk Hang Hospital (WCHH)
(5) Nursing Services Division, Cheshire Home, Chung Hom Kok (CCH)
(6) Department of Ophthalmology, TWEH
Keyword 1: :
electronic intake and output
Keyword 2: :
intake and output
Keyword 3: :
electronic documentation
Introduction :
Accurate intake and output records are crucial for assessing the hydration status of hospitalized patients. To enhance the quality of these records, RTSKH, TWEH, CCH, and WCHH adopted an electronic intake and output (e-I&O) system to replace paper forms in selected wards.
Objectives :
-Identify determinants for adopting e-I&O.
-Apply implementation strategies to further roll out e-I&O.
-Review staff acceptance to guide long-term sustainability.
Methodology :
The study used the Implementation Science PEDALs model (Problem, Evidence, Determinants, Actions, Scale, Long-term Sustainment) to guide staff acceptance reviews and facilitate further roll-out. Healthcare workers who were working in wards with e-I&O participated in a quantitative study using the Technology Acceptance Model (TAM) and the Post-Study System Usability Questionnaire (PSSUQ). After reviewing initial findings, strategies were implemented to promote adoption in other clinical settings. A second quantitative survey with the same instruments was conducted post-implementation.
Result & Outcome :
Phase I involved 84 healthcare workers (response rate: 72.41%). The mean TAM score was 3.31 (on a 7-point scale, where 1 is "very good" and 7 is "very poor"), and the mean PSSUQ score was 3.38, indicating neutral to slightly positive acceptance. Following strategy implementation, e-I&O was adopted in three additional clinical areas. In Phase II, 67 respondents participated (response rate: 69%). The mean TAM score improved to 2.95, and the mean PSSUQ score improved to 2.94. Though improvements were not statistically significant (TAM: p = 0.202; PSSUQ: p = 0.114), the trends were positive. Staff computer skills significantly impacted system adoption, as demonstrated by both phases of the survey (TAM & PSSUQ: p-value < 0.05). The Implementation Science approach guided the roll-out of the e-I&O system. User acceptance surveys suggested that the implementation strategies led to an improvement in the acceptance of e-I&O system adoption.
