Implementing INTERACT-SBAR Tool

Reflect on your draft review of literature. Discuss how you anticipate your DNP project will contribute to the scientific body of evidence. What research-to-practice gap have you identified? How do you plan to address this need? Did you identify any gaps in the literature that may require more research and prevent translation into practice at this time? What questions will your proposed project answer, have they changed from your original idea?

NOTE: My project is guided by the following PICOT question β€œIn post-acute patients (P) admitted in Skilled Nursing Facility, does implementing INTERACT-SBAR Tool (I), compared to no INTERACT-SBAR Tool (C), reduce rehospitalization (O) within 8 weeks (T)?”

The proposed DNP project aims to contribute to the scientific body of evidence by addressing a research-to-practice gap in the effective management of post-acute care transitions for patients admitted to skilled nursing facilities (SNFs). The implementation of the INTERACT-SBAR Tool is anticipated to facilitate improved communication and coordination between SNFs and healthcare providers, ultimately reducing the risk of rehospitalization among this vulnerable patient population.

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The literature review has identified a significant need for enhanced communication strategies and standardized processes to ensure safe and effective transitions of care for patients discharged from acute care settings to SNFs (Ouslander et al., 2016). Despite the well-documented challenges associated with care transitions, there remains a lack of widespread adoption of evidence-based interventions to address this issue (Toles et al., 2020). The INTERACT-SBAR Tool, which combines the INTERACT quality improvement program with the structured SBAR (Situation, Background, Assessment, Recommendation) communication framework, has shown promise in improving communication and reducing rehospitalizations (Ouslander et al., 2019; Tappen et al., 2017).

While the existing literature supports the potential benefits of the INTERACT-SBAR Tool, there is a need for further research to evaluate its effectiveness in diverse SNF settings and patient populations (Ouslander et al., 2019). Additionally, the successful implementation of this intervention may require addressing potential barriers, such as staff training, resource availability, and organizational culture (Toles et al., 2020; Vogelsmeier et al., 2018).

The proposed DNP project aims to address this research-to-practice gap by implementing the INTERACT-SBAR Tool in a local SNF setting and evaluating its impact on reducing rehospitalizations within an 8-week timeframe. The project will contribute to the scientific body of evidence by providing insights into the real-world implementation challenges and potential benefits of this intervention in a specific healthcare context.

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Furthermore, the project may identify additional gaps in the literature or areas requiring further research, such as the long-term sustainability of the intervention, its adaptability to diverse patient populations, or its integration with other quality improvement initiatives.

References:

Ouslander, J. G., Nakas, N. A., Abrahamson, K., Bernstein, J., Caprio, T. V., Comer, M., … & Zimnavoda, E. (2019). Implementing the INTERACTβ„’ quality improvement program in US nursing homes: a process evaluation study. BMC Health Services Research, 19(1), 1-13. https://doi.org/10.1186/s12913-019-4732-4

Ouslander, J. G., Bonner, A., Herndon, L., & Shutes, J. (2016). The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: an overview for medical directors and primary care clinicians in long-term care. Page Essay – Journal of the American Medical Directors Association, 17(3), 182-189. https://doi.org/10.1016/j.jamda.2015.12.076

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Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Tofle, R., Carpenter, B., … & Curyto, K. (2017). Barriers and facilitators to implementing a reengineered nursing home care model in a local market. Page Essay – Journal of the American Medical Directors Association, 18(4), 340-345. https://doi.org/10.1016/j.jamda.2016.09.019

Toles, M., Ouslander, J., Bognar, B., & Hirsch, E. (2020). Implementing INTERACT in a nursing home to improve acute care transfers: a case study. Page Essay – Journal of the American Medical Directors Association, 21(9), 1297-1301. https://doi.org/10.1016/j.jamda.2020.01.007

Vogelsmeier, A., Popejoy, L., & Kist, S. (2018). Barriers and facilitators to implementing a nursing home QI intervention: An exploratory study using CFIR. Page Essay – Journal of Nursing Care Quality, 33(4), 314-321. https://doi.org/10.1097/NCQ.0000000000000333