Usability Test for Critical IllnessToolkit

Description of Usability Test:

The usability test will be done to test the usability and adaptability of the all forms found in the Critical Illness Toolkit. Each recruited participant will receive the instructions for via email on how to download the complete Toolkit as well as howto complete the surveys. Participants will have60 daysto use the forms and complete three surveys, which will be done electronically on the Evidence Analysis Library website.

Objectives:

  • To determine the usability of the toolkit with regard to:
  • Format
  • Spacing
  • Wording
  • Organization
  • Clarity
  • Usefulness of Content
  • Application
  • Efficiency
  • Effectiveness in Collecting Outcomes
  • Effectiveness in Communicating to Other Health Care Professionals

Timeline and Important Dates:

Recruiting: February-March 2008

Usability Test: April-May-June 2008(60-days)

Welcome letter:April 2008

Materials sent to participants: April 2008

Training:

  1. Orientation - each participant should plan to attend oneof the 90-minute Webinar/conference call sessions:

April 2008 – dates TBD

  1. Nutrition Care Process/Standardized Language training- each participant is required to review NCP Tutorials available online at

Form Usage and Survey Completion:

Survey #1: dates -TBD

Survey #2 and #3: dates-TBD

Inclusion:

Sixteen registered dietitians will be recruited through the Dietetic Practice-Based Research Network. Two alternates will be identified to fill in for participants who may resign from the usability test. Each participant must meet the following criteria:

  • Work with adult patients who are critically ill (in the Intensive Care Unit) who requires nutrition support.
  • Medical and surgical conditions may include those in which the patient requires care for:
  • Sepsis and systemic inflammatory response syndrome (SIRS)
  • Trauma
  • Head injury
  • Pancreatitis
  • Respiratory failure
  • Neurological injury
  • Multi-organ failure.
  • Have computer and internet access
  • Able to complete records on five patients during the 60-day period
  • Willing to duplicate documentation to adhere to protocol
  • Have approval from immediate supervisor
  • Ideally, eight of the participants are documenting in an electronic medical record and eight documenting in a paper medical record
  • Participants may be required to obtain approval or “exempt” from their facility Institutional Review Board for participation in the study.

Procedure:

Welcome Letter: Each participant will receive a welcome letter for participation via email, which includes:

  • Full description of the Usability Test for Critical Illness Toolkit
  • “Supervisor and Site Approval” form– to be completed and faxed to Kari Kren at 312-899-4796
  • “Notification of IRB Status” form – to be completed and faxed to Kari Kren at 312-899-4796

Participant Preparation: Each participant will be able to view the toolkit materials before the training sessions. Participants will also be required to complete a brief informational form to provide current demographic data.

Training Sessions:Each participant will be required to attendone of the two Webinar/conferencecallorientation-training sessions. Attendance is via computer/phone.

  • The training session will cover the following:
  • Navigating through the Critical Illness Evidence-Based Nutrition Practice Guideline and Toolkit
  • Review of Toolkit contents
  • Review of three-part survey

Each participant is required to review the 12 NCP Tutorials online about the Nutrition Care Process/Standardized Language which will provide an overview of how to use Nutrition Diagnosis, NutritionInterventionand Nutrition Monitoring and Evaluation Standardized language during the documentation process using the toolkit.

Survey Completion:Participants will be given a 60-daytime period after the training session, to use the Toolkit and complete each section of the online survey.The survey will be organized into three sections that will be related to the forms which each participant is using at that period of time. Email reminder notifications will be sent prior to each survey deadline, the sections are as follows:

Survey #1: Questions regarding initial encounter forms- to be completed after the initial encounter with five patients.

Survey #2: Questions regarding the follow-up encounter forms – to be completed after the follow-up encounter with five patients.

Survey #3: Questions regarding the overall toolkit- to be completed after every form has been reviewed and used.

Follow up:

The point of contact for the participants will be Kari Kren. The email address and phone number of the point of contact will be provided for ongoing questions related to the toolkit and completing the survey ( or 800-877-1600 ext.4877). A response will be provided within 48 hours of all questions. Aconference call will be performed every week during the testing period to answer questions for participants (call dates/times will be determined during training sessions).A participant contact log will be kept by the point of contact, and a list of frequently asked questions recorded.

Toolkit materials include:

  1. Overview of Critical Illness Toolkit
  2. Medical Nutrition Therapy Protocol Forms for Implementing Critical Illness Evidence-Based Nutrition Practice Guideline
  3. Medical Nutrition Therapy Summary Page for Critical Illness
  4. Medical Nutrition Therapy Flowchart of Encounters for Critical Illness
  5. Common Nutrition Diagnoses for Critical Illness & Figure
  6. Medical Nutrition Therapy Encounter Process for Critical Illness
  1. Documentation Forms/Case Studies
  2. Enteral Nutrition Protocol
  3. Medical Nutrition TherapyCritical Illness Enteral Nutrition Progress Note
  4. Medical Nutrition TherapyCritical Illness Enteral Nutrition Progress Note
  5. Sample Case Study 1
  6. Sample Case Study 2
  7. Parenteral Nutrition Protocol
  8. MNTCritical Illness Parenteral Nutrition Progress Note
  9. MNTCritical Illness Parenteral Nutrition Progress Note
  1. Outcomes Management Forms
  2. Outcomes Management: Nutrition Monitoring and Evaluation
  3. Outcomes Management Forms in Excel
  1. Appendices
  2. Appendix 1: Excel Formulas
  3. Appendix 2: Additional Resource List

Procedure for Using Toolkit:

Each participant will be instructed to read all forms within the toolkit thoroughly and complete the forms listed below. The survey questions will involve all materials in the toolkit. It is expected that participants will enroll five patients when testing the forms prior to completing the surveys (i.e. use each five times).

Participants will complete the following documentation forms for five patients:
Medical Nutrition TherapyCritical Illness Enteral Nutrition Progress Note
Medical Nutrition TherapyCritical Illness Enteral Nutrition Progress Note
Medical Nutrition TherapyCritical Illness Parenteral Nutrition Progress Note
Medical Nutrition TherapyCritical Illness Parenteral Nutrition Progress Note
Outcomes Monitoring Form
Participants will read/useall other forms in the table of contents.

If participants are using an electronic medical record for their documentation, they can download the files and the patient information can be typed within the document and then copied to the electronic medical record file.

Protection of Patient Information

Patient information will be protected during the usability test to ensure that patients cannot be directly or indirectly identified. The data being collected during the test does not fall into the category of Protected Health Information ad defined under HIPAA. In order to protect patient information and meet research study criteria, participants should follow the guidelines below:

  • Do not place any of the toolkit test forms into your current medical records during the usability test. Duplication of work may be necessary to complete the test (e.g. assessment forms, progress notes, follow-up notes, etc.).
  • Do not share any patient information with ADA or other usability test participants. The objectives involve using the forms and providing your feedback about the usability of the forms by answering the questions in the evaluation.

Survey Components:The survey will be done electronically and accessed throughthe Evidence Analysis Library website. Each question will be asked using a Likert Scale as the response (i.e. strongly agree, disagree, neither agree nor disagree, agree, strongly agree and N/A) and providing areas for comments.

Collecting and Determining Results:

Results from the online survey will be totaled electronically and available for reviewing by the Evidence-Based Practice Committee. Participants will be notified that ADA only reports aggregated survey information and does not identify individual usability test participants. Survey results will be used to revise the toolkit prior to publication.

Incentive:

All participants will receive a $50.00 gift certificate for the ADA Product Catalogue to be mailed after the completion of the usability test.

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