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Comparison of the effectiveness of two protocols for treating nursing home residents with advanced dementia. Res Gerontol Nurs 2012 Oct;5(4):251-63 PMID: 22998656 PMCID: PMC3475742

Pubmed ID



The Serial Trial Intervention (STI) is a decision support tool to address the problem of underassessment and undertreatment of pain and other unmet needs of people with dementia. This study compared the effectiveness of the 5-step and 9-step versions of the STI using a two-group repeated measures quasi-experimental design with randomization of 12 matched nursing homes. The sample consisted of 125 residents with moderate to severe dementia. Both the 5- and 9-step STIs significantly decreased discomfort and agitation from pre- to posttest (effect sizes = 0.45 to 0.90). The 9-step version was more effective for comorbid burden and increased cortisol slope (effect sizes = 0.50 and 0.49). Process variables were all statistically significantly improved using the 9-step STI. Nurse time was not different between the two groups. The clinical decision support rules embedded in the STI, particularly the 9-step version, helped nurses change practice and improved resident outcomes.

Author List

Kovach CR, Simpson MR, Joosse L, Logan BR, Noonan PE, Reynolds SA, Woods DL, Raff H


Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Hershel Raff PhD Professor in the Medicine department at Medical College of Wisconsin


2-s2.0-84868137885   13 Citations

MESH terms used to index this publication - Major topics in bold

Clinical Protocols
Double-Blind Method
Nursing Homes
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6