Predicting Respiratory Therapists' Intentions to Use the Modified Early Warning Score by Using an Enhanced Technology Acceptance Model

BACKGROUND: The modified early warning score (MEWS) is used to detect early clinical deterioration and to escalate care as needed. Respiratory therapists (RTs) usually do not use the MEWS even when it is implemented as a default in the electronic health record system. This study explored whether the technology acceptance model could predict the intentions of RTs to use the MEWS. METHODS: A validated survey that uses a pretest/posttest design was used to determine the effect of an educational intervention (lecture and interactive small group session) on RTs' MEWS knowledge. We also measured key determinants of the intention by RTs to use the MEWS based on the constructs of the technology acceptance model. The survey was distributed to 75 RTs employed at a Midwestern academic medical center. RESULTS: There was a 61% survey response rate. Statistical analysis of the survey data demonstrated that the educational intervention increased the MEWS knowledge score from 2.0 before education to 4.0 after education (P <.001). Moreover, there was a statistically significant increase in the behavioral intention score, from 3.0 before education to 4.0 after education (P <.001). Partial least squares structural equation modeling revealed that MEWS knowledge influenced perceived ease of use, which influenced attitude, which influenced behavioral intention. CONCLUSIONS: Numerous studies have demonstrated that a change in behavioral intention is a good predictor of change in behavior. The increase in the RTs' knowledge, attitude, and behavioral intention scores after MEWS education indicated that these RTs may be more inclined to use the MEWS if they were educated about its clinical relevance and if their attitude toward using it were favorable. Analysis of the study results also indicated that the technology acceptance model could serve as a framework to guide respiratory care managers in the development of strategies to successfully implement new systems or processes that are intended to be used by RTs.