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Course Overview

This activity introduces a new communication tool based on the principles of effective standardized communication: SBAR. SBAR stands for Situation, Background, Assessment, and Recommendation. The material included here will teach about how to use SBAR to improve communication about warfarin. The skills taught have applications for other clinical areas as well—SBAR has been used to address a variety of communication challenges in diverse settings.

The first presentation, Structured Communication About Warfarin and Patient Safety, addresses the basics of warfarin management for nurses and introduces the structured communication technique of SBAR.

The second presentation, Focused Assertive Communication for Nurses, addresses common challenges to communication that nurses face in the nursing home. These are based on interviews with many nurses in the long-term care setting. This presentation also offers strategies for addressing these challenges and recommendations for assertive communication.

In addition to the CE presentations, the supplemental materials page offers exercises, role play and other information to promote implementation of the techniques introduced in the presentations.

Educational Objectives

Structured Communication About Warfarin and Patient Safety

At the conclusion of this presentation, the participant should be able to:

• Discuss the principles of warfarin safety.
• Describe the importance of communication in the safe use of warfarin for nursing home residents.
• State the role of SBAR in communicating information to physicians about nursing home residents who are on warfarin therapy.
• Complete each section of the SBAR form for residents taking warfarin in their nursing home.

Focused Assertive Communication for Nurses

At the conclusion of this presentation, the participant should be able to:

• Discuss the importance of preparing and collecting relevant information before placing a call about a patient to a physician.

Target Audience

This CE activity is designed to meet the educational needs of nurses working in a long-term care setting who care for patients on warfarin therapy or for any nurse seeking to improve their nurse-physician communication skills.

Method of Participation

This activity is comprised of two presentations that may be viewed in one or more of these formats:

• Video/audio
• Text/slides
• Printable PDF

To receive a maximum of 1.0 credit, you should:

• View the presentations in this enduring material program.
• Complete and submit the CE registration, posttest, and activity evaluation form; you must achieve a score of 80% on the posttest to receive credit.

The estimated time to complete this activity, including review of the materials, is 1.0 hours.

For additional helpful resources (e.g., training tools, exercises, and role-playing scripts), visit the supplemental materials page of this activity. Please note that CE credit is not offered for materials offered on the supplemental materials page.

Accreditation Statement/Designation of Credit

The University of Texas Health Science Center at Houston School of Nursing an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

The number of contact hours awarded for this educational activity is 1.0 contact hour.

Accreditation by the American Nurses Credentialing Center's Commision on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product.

Instructions for Participants

This activity is provided free of charge to participants. In order to receive credit, practitioners must participate in the activity for at least 1.0 hour and complete the registration, evaluation, posttest, and request for credit form. Partial credit may be awarded. Statements of continuing education credit may be printed upon submission of the post-test, activity evaluation, and request for credit forms.

Term of Approval

July 2012 through July 2014. Original release date: July 2010.

Peer Review

In June 2010, this continuing education online enduring material was reviewed by Marcus Reidenberg, M.D., professor of medicine, pharmacology, and public health at the Weill Cornell Medical College, and Michael Fordis, M.D., senior associate dean and director of Office of Continuing Medical Education at Baylor College of Medicine. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in June 2012.

Disclosure:

• Marcus Reidenberg, M.D., peer reviewer: advisory committee membership — Hoffmann LaRoche, Ascenta; consultancy The Medicines Company, ownership interests — Ascenta. Patent royalties — patient rights owned by NIH and licensed to Ascenta.
• Michael Fordis, M.D., peer reviewer: nothing to disclose.

Disclaimer

This CE activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Every effort has been made to have accurate information presented; no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

It is the policy of The University of Texas Health Science Center at Houston School of Nursing Department of Continuing Education to ensure balance, independence, objectivity and scientific rigor in all of its continuing nursing education activities. The CE office has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within the prior 12 months; and 2) of their spouses/partners.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the course evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

• Terry S. Field, D.Sc., contributor: nothing to disclose.
• Jerry Gurwitz, M.D., contributor: nothing to disclose.
• Jennifer Tjia, M.D., M.S.C.E., contributor: nothing to disclose.
• Kathleen Mazor, Ed.D., contributor and narrator: nothing to disclose.

There was no off-label use of warfarin discussed in this activity.

Acknowledgement of Support

This CE activity is supported by an Agency for Healthcare Research and Quality grant titled,Randomized Trial of a Warfarin Management Protocol for Communication Between Nursing Home Staff and Prescribing Physicians (Grant Number: R01HS016463).