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Condition-Specific SBAR use in Long Term Care and its Effect on Nurse Perception of Nurse-Physician Communication and Acute Care Hospitalizations: A Pilot Study

Devereaux, Terri (2016) Condition-Specific SBAR use in Long Term Care and its Effect on Nurse Perception of Nurse-Physician Communication and Acute Care Hospitalizations: A Pilot Study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Terri Devereaux PhD, MPM, FNP-BC
University of Pittsburgh, 2016

Ineffective communication between physicians and nurses leads to transfer of LTC residents to acute care, with up to 67% found to be avoidable. A currently used Situation, Background, Assessment, Recommendation (SBAR) communication tool requires nurses to discern and organize pertinent data to report, which may limit its usefulness and impact on communication. This study tested whether using a SBAR tool specific to changes in condition for nurses in LTC to collect and report pertinent information improves nurses’ perception of nurse/physician communication and decreases the number of acute care hospitalizations.
A quasi-experimental one group pre/posttest was conducted to test condition-specific SBARs (CS SBARs) for the most common reasons for transfer to acute care. All RNs (n=27) and LPNs (n=33) at a 139-bed skilled nursing/post-acute care nursing facility participated. A survey to measure nurse perception of quality of nurse-physician communication, transfers, hospitalizations, and 30-day readmissions to acute care data were collected for a 3 month period pre and post intervention.
Due to high nursing turnover rates adequate power was not achievable to measure perception of quality of nurse-physician communication with confidence. Frustration was the only item with a significant change, an increase post-implementation (p=.04). A significant reduction in transfers (0.44 vs. 0.24, p<.001), hospital unplanned admissions (0.34 vs. 0.18, p=.004); 30-day readmissions (0.12 vs. 0.04, p=.011) was observed 3 months post-implementation. Avoidable transfers were significantly reduced (0.59 vs. 0.41, p=.001) as were avoidable hospital admissions (0.45 vs. 0.25, p=.003). A significant reduction in transfers due to pneumonia (0.53 vs .0.17, p=.014) was observed. No other significant condition-specific transfer reductions were observed. This study suggests that using CS SBARs when a change in resident condition occurs reduces transfers/hospitalizations/30-day readmissions and when transfers did occur, they were more likely to unavoidable, suggesting that residents were more likely to receive appropriate care in the most appropriate setting. All 30-day readmissions except one were from post-acute care suggesting that perhaps acute care transfers to LTC are not occurring at the optimal time. Estimated Medicare and Medicaid cost savings was $246,247.
Limitations of the study were small sample size and study was conducted at one facility.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Devereaux, Territld42@pitt.eduTLD42
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairWatzlaf, Valerievalgeo@pitt.eduVALGEO
Committee MemberEngberg, Sandra J.sje1@pitt.eduSJE1
Committee MemberMarchetti,
Committee MemberParmanto, Bambangparmanto@pitt.eduPARMANTO
Committee MemberZionts,
Date: 2 June 2016
Date Type: Publication
Defense Date: 2 March 2016
Approval Date: 2 June 2016
Submission Date: 24 February 2016
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 134
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Health Information Management
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Condition-Specific SBAR SBAR Nurse Physician Communication Long Term Care Transfers Hospitalizations 30-day Readmissions Acute Care
Date Deposited: 02 Jun 2016 12:52
Last Modified: 02 Jun 2018 05:15


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