Trial reportThe American journal of medicine2011
Randomized trial of a warfarin communication protocol for nursing homes: an SBAR-based approach.
Trial report in The American journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 6 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Systematic Review and Meta-analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults: An Update.Drugs & aging · 2023Pooled it
- Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review.BMJ open · 2021Pooled it
- Setting Priorities to Inform Assessment of Care Homes' Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process.International journal of environmental research and public health · 2020Pooled it
- Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review.BMJ open · 2018Pooled it
- Meta-analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults.Journal of the American Geriatrics Society · 2018Pooled it
- Educational and behavioural interventions for anticoagulant therapy in patients with atrial fibrillation.The Cochrane database of systematic reviews · 2017Pooled it
- Effectiveness and Health Outcomes of Collaborative Nurse Prescribing for Patients Anticoagulated with Antivitamin K in Primary Care: A Study Protocol.Healthcare (Basel, Switzerland) · 2024Article
- Improving Communication in Nursing Homes Using Plan-Do-Study-Act Cycles of an SBAR Training Program.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2023Article
- Development of communication tool for resident- and family-led care discussions in long-term care through patient and family engagement.International journal of older people nursing · 2022Article
- 'This Adds Another Perspective': Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes.International journal of environmental research and public health · 2021Article
- Barriers and facilitators to optimal oral anticoagulant management: a scoping review.Journal of thrombosis and thrombolysis · 2020Article
- Article
- Use of Notification and Communication Technology (Call Light Systems) in Nursing Homes: Observational Study.Journal of medical Internet research · 2020Observational
- Measuring Harm in Health Care: Optimizing Adverse Event Review.Medical care · 2017Article
- Guidance for the practical management of warfarin therapy in the treatment of venous thromboembolism.Journal of thrombosis and thrombolysis · 2016Review
- The nursing home population: an opportunity to make advances on research on multimorbidity and polypharmacy.The journal of nutrition, health & aging · 2013Article
- A handoff is not a telegram: an understanding of the patient is co-constructed.Critical care (London, England) · 2012Review
- Predicting nursing home adherence to a clinical trial intervention: lessons for the conduct of cluster randomized trials.Journal of the American Geriatrics Society · 2011Article
- Examining the feasibility and utility of an SBAR protocol in long-term care.Geriatric nursing (New York, N.Y.)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMore than 1.6 million Americans currently reside in nursing homes. As many as 12% of them receive long-term anticoagulant therapy with warfarin. Prior research has demonstrated compelling evidence of safety problems with warfarin therapy in this setting, often associated with suboptimal communication between nursing home staff and prescribing physicians.
methodsWe conducted a randomized trial of a warfarin management protocol using facilitated telephone communication between nurses and physicians in 26 nursing homes in Connecticut in 2007-2008. Intervention facilities received a warfarin management communication protocol using the approach "Situation, Background, Assessment, and Recommendation" (SBAR). The protocol included an SBAR template to standardize telephone communication about residents on warfarin by requiring information about the situation triggering the call, the background, the nurse's assessment, and recommendations.
resultsThere were 435 residents who received warfarin therapy during the study period for 55,167 resident days in the intervention homes and 53,601 in control homes. In intervention homes, residents' international normalized ratio (INR) values were in the therapeutic range a statistically significant 4.50% more time than in control homes (95% confidence interval [CI], 0.31%-8.69%). There was no difference in obtaining a follow-up INR within 3 days after an INR value ≥4.5 (odds ratio 1.02; 95% CI, 0.44-2.4). Rates of preventable adverse warfarin-related events were lower in intervention homes, although this result was not statistically significant: the incident rate ratio for any preventable adverse warfarin-related event was .87 (95% CI, .54-1.4).
conclusionFacilitated telephone communication between nurses and physicians using the SBAR approach modestly improves the quality of warfarin management for nursing home residents.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.