Raising the Bar With Sbar (QI Abstract)

Abstract

Miscommunication contributes to over 60% of serious adverse events in the hospital. Structured communication may be one solution for reducing errors in patient handoffs. One communication framework is SBAR (Situation, Background, Assessment, Recommendation). Aim Statement We instituted SBAR for nurse updates by resident physicians and examined whether its use resulted in perceived improvement in communication between nurses and resident physicians on a busy inpatient ward. This IRB-exempted QI project ran from July 2015-November 2016 on a 20-bed pediatric ward. Interventions Residents and nurses completed pre-intervention surveys assessing perceived quality of communication between residents and nurses. After residents completed at least 1 inpatient month they were trained to use SBAR by a certified instructor. SBAR was then used to transmit patient care plans to nurses after rounds. After multiple PDSA cycles, weekly text reminders and tracking sheets were implemented to optimize SBAR use. After 1 year, nurses and residents completed the post-intervention survey. Measures Quality of communication and comprehension of action plans were assessed by 9 questions, using a 5-point scale. Surveys were completed anonymously to improve response. Unmatched pre- and post-intervention responses were compared for nurses and residents using chi-square analysis.