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A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study

BACKGROUND: Chronic kidney disease (CKD) is a health condition that threatens patient safety; however, few interventions provide patient-centered education about kidney-specific safety hazards. OBJECTIVE: We sought to develop and test the usability of a mobile tablet–based educational tool designed...

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Autores principales: Bowman, Cassandra, Lunyera, Joseph, Alkon, Aviel, Boulware, L Ebony, St Clair Russell, Jennifer, Riley, Jennie, Fink, Jeffrey C, Diamantidis, Clarissa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290458/
https://www.ncbi.nlm.nih.gov/pubmed/32463366
http://dx.doi.org/10.2196/16137
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author Bowman, Cassandra
Lunyera, Joseph
Alkon, Aviel
Boulware, L Ebony
St Clair Russell, Jennifer
Riley, Jennie
Fink, Jeffrey C
Diamantidis, Clarissa
author_facet Bowman, Cassandra
Lunyera, Joseph
Alkon, Aviel
Boulware, L Ebony
St Clair Russell, Jennifer
Riley, Jennie
Fink, Jeffrey C
Diamantidis, Clarissa
author_sort Bowman, Cassandra
collection PubMed
description BACKGROUND: Chronic kidney disease (CKD) is a health condition that threatens patient safety; however, few interventions provide patient-centered education about kidney-specific safety hazards. OBJECTIVE: We sought to develop and test the usability of a mobile tablet–based educational tool designed to promote patient awareness of relevant safety topics in CKD. METHODS: We used plain language principles to develop content for the educational tool, targeting four patient-actionable safety objectives that are relevant for individuals with CKD. These four objectives included avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs); hypoglycemia awareness (among individuals with diabetes); temporary cessation of certain medications during acute volume depletion to prevent acute kidney injury (ie, “sick day protocol”); and contrast dye risk awareness. Our teaching strategies optimized human-computer interaction and content retention using audio, animation, and clinical vignettes to reinforce themes. For example, using a vignette of a patient with CKD with pain and pictures of common NSAIDs, participants were asked “Which of the following pain medicines are safe for Mr. Smith to take for his belly pain?” Assessment methods consisted of preknowledge and postknowledge surveys, with provision of correct responses and explanations. Usability testing of the tablet-based tool was performed among 12 patients with any stage of CKD, and program tasks were rated upon completion as no error, noncritical error (self-corrected), or critical error (needing assistance). RESULTS: The 12 participants in this usability study were predominantly 65 years of age or older (n=7, 58%) and female (n=7, 58%); all participants owned a mobile device and used it daily. Among the 725 total tasks that the participants completed, there were 31 noncritical errors (4.3%) and 15 critical errors (2.1%); 1 participant accounted for 30 of the total errors. Of the 12 participants, 10 (83%) easily completed 90% or more of their tasks. Most participants rated the use of the tablet as very easy (n=7, 58%), the activity length as “just right” (rather than too long or too short) (n=10, 83%), and the use of clinical vignettes as helpful (n=10, 83%); all participants stated that they would recommend this activity to others. The median rating of the activity was 8 on a scale of 1 to 10 (where 10 is best). We incorporated all participant recommendations into the final version of the educational tool. CONCLUSIONS: A tablet-based patient safety educational tool is acceptable and usable by individuals with CKD. Future studies leveraging iterations of this educational tool will explore its impact on health outcomes in this high-risk population.
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spelling pubmed-72904582020-06-19 A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study Bowman, Cassandra Lunyera, Joseph Alkon, Aviel Boulware, L Ebony St Clair Russell, Jennifer Riley, Jennie Fink, Jeffrey C Diamantidis, Clarissa JMIR Form Res Original Paper BACKGROUND: Chronic kidney disease (CKD) is a health condition that threatens patient safety; however, few interventions provide patient-centered education about kidney-specific safety hazards. OBJECTIVE: We sought to develop and test the usability of a mobile tablet–based educational tool designed to promote patient awareness of relevant safety topics in CKD. METHODS: We used plain language principles to develop content for the educational tool, targeting four patient-actionable safety objectives that are relevant for individuals with CKD. These four objectives included avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs); hypoglycemia awareness (among individuals with diabetes); temporary cessation of certain medications during acute volume depletion to prevent acute kidney injury (ie, “sick day protocol”); and contrast dye risk awareness. Our teaching strategies optimized human-computer interaction and content retention using audio, animation, and clinical vignettes to reinforce themes. For example, using a vignette of a patient with CKD with pain and pictures of common NSAIDs, participants were asked “Which of the following pain medicines are safe for Mr. Smith to take for his belly pain?” Assessment methods consisted of preknowledge and postknowledge surveys, with provision of correct responses and explanations. Usability testing of the tablet-based tool was performed among 12 patients with any stage of CKD, and program tasks were rated upon completion as no error, noncritical error (self-corrected), or critical error (needing assistance). RESULTS: The 12 participants in this usability study were predominantly 65 years of age or older (n=7, 58%) and female (n=7, 58%); all participants owned a mobile device and used it daily. Among the 725 total tasks that the participants completed, there were 31 noncritical errors (4.3%) and 15 critical errors (2.1%); 1 participant accounted for 30 of the total errors. Of the 12 participants, 10 (83%) easily completed 90% or more of their tasks. Most participants rated the use of the tablet as very easy (n=7, 58%), the activity length as “just right” (rather than too long or too short) (n=10, 83%), and the use of clinical vignettes as helpful (n=10, 83%); all participants stated that they would recommend this activity to others. The median rating of the activity was 8 on a scale of 1 to 10 (where 10 is best). We incorporated all participant recommendations into the final version of the educational tool. CONCLUSIONS: A tablet-based patient safety educational tool is acceptable and usable by individuals with CKD. Future studies leveraging iterations of this educational tool will explore its impact on health outcomes in this high-risk population. JMIR Publications 2020-05-28 /pmc/articles/PMC7290458/ /pubmed/32463366 http://dx.doi.org/10.2196/16137 Text en ©Cassandra Bowman, Joseph Lunyera, Aviel Alkon, L Ebony Boulware, Jennifer St Clair Russell, Jennie Riley, Jeffrey C Fink, Clarissa Diamantidis. Originally published in JMIR Formative Research (http://formative.jmir.org), 28.05.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Bowman, Cassandra
Lunyera, Joseph
Alkon, Aviel
Boulware, L Ebony
St Clair Russell, Jennifer
Riley, Jennie
Fink, Jeffrey C
Diamantidis, Clarissa
A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title_full A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title_fullStr A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title_full_unstemmed A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title_short A Patient Safety Educational Tool for Patients With Chronic Kidney Disease: Development and Usability Study
title_sort patient safety educational tool for patients with chronic kidney disease: development and usability study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290458/
https://www.ncbi.nlm.nih.gov/pubmed/32463366
http://dx.doi.org/10.2196/16137
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