Table 3.

Perceived barriers to implementation and strategies used to address these barriers.

Barrier or concerns identified by nurses	Illustrative quote	Strategies used to address concerns or barriers
Potential burden of introducing the intervention for nursing staff	“Can you guarantee this [iPad intervention] will not increase our already busy workload? I mean, if we have to spend time going through this iPad [intervention] then it’s going to make it harder for us isn’t it...I mean, we just don’t have the time.” [Nurse ID 2] “I don’t know, I think there’s a lot going on in the morning...we [the nurses] are busy and flat out. First thing it is probably easier if someone else does it [goes through the program with the patient] and not leave it up to the nurses?” [Nurse ID 1]	Implementation of the intervention on day 1 of patients’ recovery was carried out by the researcher to ensure that patients could use the iPad and navigate the program Patients who were classified as postoperative day 1 received an explanation of the iPad and navigation after handover and before breakfast, at approximately 8 AM each day
The age of patients and ease of use of technology	“With the older patients we may have to teach them how to use the iPad [intervention] or they may not be able to use it at all. Do you think this is very realistic, I mean for them to use it?” [Nurse ID 3] “Yes, some of them have other comorbidities, you know, such as arthritis, it may be harder for them...we will have to push it for them? If that’s the case, I don’t think we will have the time.” [Nurse ID 4] “I don’t think it should be an issue, my grandparents have one and they use it ok.” [Nurse ID 1]	A flyer to assist patients to navigate the program themselves was provided to all patients Once patients were familiar with the iPad the nurses felt that they were able to focus on the content of the program
Security and safety of the equipment and infection control	“So where are you going to put it [iPad intervention]? You don’t want it to get in the way. There’s not much room anyway with all their [patients] stuff. Perhaps it could be put on the bedside tables so we can get it out of the way if we need to?...What about keeping it clean, what do you think?...Have you thought about the cross contamination?” [Nurse ID 1] “Yes, you have to make sure it doesn’t walk either...if it’s not secure, things walk here, how will you make sure it stays with the patient? And what about if it gets dropped they are very sensitive these iPads...what will happen there...do you have lots of replacements?” [Nurse ID 3]	To address security concerns, the iPad was secured to each patient’s movable bedside table with a locked cable Each iPad was secured inside a locked tough case that was drop-, smash-, and splash-proof The infection control nurse approved the cleaning protocol for each iPad before transfer to another patient. Wiping the iPad and all associated material (cords, case, etc) with an alcohol-impregnated cloth was approved as sufficient cleaning between patients Cleaning occurred on collection of the iPad when a participating patient was discharged from hospital