Date of Award

5-2021

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Linda I. Shuster

Second Advisor

Dr. Natalie Douglas

Third Advisor

Dr. Steven Eberth

Keywords

Whiteboard, bedside, skilled nursing, communication, safety, in-room

Abstract

The application of research to practice is a difficult task to successfully carry out for many healthcare professionals and organizations. The Promoting Action on Research Implementation in Health Services (PARIHS) framework is a tool that acts as an implementation guide for translating research evidence to practice. This study explored the use of an adapted version of the PARIHS framework as a guide to implementing in-room whiteboards in a skilled nursing facility (SNF) on their short-term rehabilitation wing. While the utility of in-room whiteboards has been demonstrated in the acute care setting, there are few studies of their use in SNFs. This study also aimed to determine whether in-room whiteboards might improve the SNF’s patient safety measures, including numbers of falls and rehospitalizations.

Data were collected on the 33-bed short-term rehabilitation unit of the SNF. Two pre-implementation meetings were completed with the SNF leadership team that involved discussing the PARIHS framework and establishing plans for implementation, while recognizing not only the strengths of the facility, but also potential barriers to implementation. A follow-up meeting was conducted with the leadership team seven and a half months after whiteboard implementation to debrief on the intervention, and the utility of the PARIHS framework for planning the intervention.

Results indicated that, while some members of the leadership team found the PARIHS framework to be useful, others found it to be cumbersome to use. They also noted that the COVID-19 Pandemic made it challenging to keep up with timely maintenance of information on the boards. However, they indicated that when the boards were used effectively, it aided in the speed and ease of information exchange. Although previous studies in the acute care setting have shown that whiteboards improved patient safety, there were no significant changes noted in the safety outcome measures of falls and rehospitalizations.

In conclusion, it appears that the PARIHS framework could be useful as a guide for implementing research evidence into a SNF setting; however, further study in additional facilities with other leadership teams is necessary to confirm its utility. In addition, future research should continue to explore the effects of whiteboard use on patient safety measures in SNFs, as the conduct of this study was affected by the pandemic.

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Dissertation-Open Access

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