Usability and Acceptability Testing of a Modified Early Warning Scoring (MEWS) Tool Using Simulation

Thursday, 25 July 2013: 8:50 AM

Jamie K. Roney, BSN, RN, CCRN1
Barbara Erin Whitley, BSN, RN2
Jessica Maples, BSN, RN1
Lexie Scarborough Futrell, MSN, RN, CCRN3
Kimberley A. Stunkard, RN3
JoAnn D. Long, RN, PhD, NEA-BC4
(1)Nursing Administration, Covenant Health, Lubbock, TX
(2)Department of Critical of Care, Covenant Health, Lubbock, TX
(3)Department of Critical Care Nursing, Covenant Health, Lubbock, TX
(4)Department of Nursing, Lubbock Christian University, Lubbock, TX

Learning Objective 1: The learner will be able to discuss Modified Early Warning Scoring (MEWS) tool usability testing using simulation

Learning Objective 2: The learner will be able to discuss Modified Early Warning Scoring (MEWS) tool acceptability testing using simulation

Purpose: Anticipating barriers when introducing a new form to nurses for incorporation into their daily routine, Kurt Lewin’s action research model for change was used as a framework for this study. The purpose was to determine usability and acceptability of the Modified Early Warning Scoring (MEWS) tool by healthcare providers from the hospital units where the tool will be implemented.  

Methods: The study used a mixed-methods design. The low-fidelity simulation selected for use in testing usability and acceptability called mock hospital was used. Mannequins were used to represent hospitalized patients in four simulated hospital rooms with four charts for each, thus matching the number of scenarios written. Realistic clinical situations encountered in practice allowed for focus on cognitive and psychological simulation fidelity. The feedback loop included closure through reflection on the experience by reviewing the simulation experiences through a structured, scripted debriefing in a comfortable place independent of distraction. An evaluation tool designed to probe usability, together with attitudes towards the instrument and the use of simulation, using 5-point likert questions and both verbal and written open ended questions was used.

Results: Six 5-point Likert questions evaluating the usability and acceptability if the MEWS tool ranged from 4.44 to 4.84. This indicated subjects ‘agreed’ to ‘strongly agreed’ that the MEWS tool was both easy to use and that attitudes towards the tool were positive about the tool’s ability to detect at-risk for deterioration patients.  The Crobach’s alpha level was .83 for the items on the Likert-type evaluation tool.  Qualitative feedback demonstrated that the participants valued the form and felt that it would easily fit into their daily routine. Notably, multiple favorable comments were also made regarding usability.

 Conclusion: Simulation was successfully used to test both usability and acceptability of a clinical screening tool for identifying the at-risk for deteriorating patient.