Situation, Background, Assessment And Recommendation Research Articles

Utilization of Phone Simulations to Assess Competency Within Nursing Education.

Phone simulations offer educators unique opportunities for teaching and assessment with reduced scheduling and location barriers. Challenges to learner assessments are multifaceted, including decreased availability of clinical sites, preceptors, and, at times, clinical instructors. This article describes the creation and implementation of diverse phone simulations at multiple levels of nursing education and provides suggestions for broader replication and adaptation. Phone simulations are easily implemented, well received, and helpful in assessing student learning and progression. At the generalist level, telephone SBAR (situation, background, assessment, and recommendation) simulations promote essential communication skills imperative in the delivery of safe and effective care. For advanced practice learners, phone simulations are easily applied across multiple populations and specialties. Guided reflections following simulation offer learners an opportunity to immediately self-remediate. Phone simulations provide adaptable opportunities to support learning and assess knowledge and competency within educational and clinical settings.

Development of an Interprofessional Handoff Assessment for Doctor of Physical Therapy Students

Background and Purpose: Handoff communication, especially interprofessional (IPE) handoff communication, has been shown to make up a large portion of communication errors in health care. There is variability in the way professionals are trained and deliver the pertinent patient information in handoffs, which, causes confusion, makes recall difficult, and increases the incidence of medical errors. Thus, this study aimed at assessing IPE handoffs for individuals who are trained in SBAR (Situation, Background, Assessment, and Recommendation) method of IPE communication developed by TEAM STEPPS®. Method: To assess IPE handoffs for those who are trained with the SBAR method, an existing tool was modified to make it more explicit to IPE handoff communication using descriptors from SBAR. Reliability and internal consistency were evaluated using videos of IPE handoffs of doctor of physical therapy (DPT) students. Results: Spearman rank coefficients for the revised assessment domains ranged from 0.56 to 0.86, indicating a strong correlation. The communication and content domains had the highest level of correlation. The interrater reliability of the 5 raters was 0.85, indicating high reliability. Discussion and Conclusion: This assessment proved to be simple and reliable to measure IPE handoff communication skills during emergent situations between DPT students and standardized nurses. Thus, this assessment can be used to assess interprofessional handoffs, develop competencies improved teamwork, and reduce medical errors.

Improving the care of patients with COVID-19 with a medical student-run telemedicine clinic

IntroductionIn March 2020, the Dallas Fort Worth Metroplex experienced a surge in acute COVID-19 infections. At that time, no consistent protocols existed for follow-up of discharged patients with COVID-19 from...

Description of the Implementation of Sbar Communication

In the application of services that refers to patient safety, there are several standards that need to be implemented, one of which is the implementation of document handover using communication with the Situation, Background, Assessment and Recommendation (SBAR) method. Communication framework using SBAR method is used when the nurse performs a handover, moves the treatment room or reports the patient's condition to the doctor. This study aims to determine the description of the inpatient wards of PTPN VIII Hospital Subang. This was a descriptive quantitative study with cross sectional approach. Respondents were nurses in the inpatient wards as many as 50 people, taken with total sampling technique, and distributing questionnaire SBAR to nurses. This study was conducted at the PTPN VIII Hospital Subang from July 2020 to August 2020. The results of this study indicated that the implementation of SBAR communication was poor due the Situation component of the nurses did not mention the age, date of admission of the patient and the nursing diagnosis. Regarding the Background component, less than half of the nurses did not mention vital signs. Reaagarding the Aassessment component, a small number of nurses did not perform the latest patient assessment, and regarding the Recommendation component more than half of the nurses did not provide ideas or recommendations to improve nursing problems. It is expected that the nurse in charge of the nursing room can implement effective communication with the SBAR method continuously and further improve information and evaluation regarding the implementation of patient identification.
 
 

Instruction Program for Nurses Knowledge about Applying the Communication Strategies (SBAR) in Critical Care Units

Background: Effective communication can improve patient care and safety by ensuring complete andcorrect information transmission and preventing misrepresentation and misinterpretation of patientcentereddata. Situation, Background, Assessment and Recommendation (SBAR) is the one of the mosteffective communication strategies that used in transmitted the clinical information between the healthprofessionals.Objectives of the Study: Present study aims to determine the effectiveness of Instruction program onnurses’ knowledge regarding communication strategy (SBAR) and find out the association betweenthe effectiveness of instruction program and nurses’ level of education, year of experiences, year ofexperiences in critical units and training course.Methodology: A pre-experimental study design was carry out in the critical care units of Imam Al-Hussein Medical City at Holy Karbala City between the periods 17th of September 2020 to 25th of May2021. A non-probability (purposive) sample of (25) nurses were selected based on the study criteria.Results: The results of the study indicated that there were high statistically differences between thepre and post-test of the instruction program related to the communication strategy. The study found ahigh statistically significant relationship between the effectiveness of the instruction program relatedto the communication strategy, educational level, training courses for nursing documentation, years ofexperience in nursing, and years of experience for nurses in the critical care units.Conclusion: The study concluded that the instruction program had a positive eefect on nurses’knowledge concerning communication strategy (SBAR).
 Recommendations: Testing the current program on a wide group of health-care providers in hospitals.

Effectiveness of the Educational Program Concerning Nurse- Midwives SBAR Tool Communication on Maternal Health Documentation at Maternal wards in Baghdad Maternity Hospitals

Background: Obstetrics is one of the most common specialties to encounter malpractice claims. Some of the obstetric malpractice claims are related to poor nurse –midwives obstetric communications. The Situation, Background, Assessment and Recommendation (SBAR) model has been suggested as a channel to facilitate effective communication between healthcare professionals, developed for health care. Objective: To assess the effect of SBAR (Situation, Background, Assessment, and Recommendation) on maternal health report documentation accuracy. To determine the effect of adopting SBAR practice and communication tool in emergency and delivery settings. To find out the differences in the practice and communication of nurse –midwives before and after SBAR implementation. To develop a script paper based on SBAR tool for nurse –midwives. To assess the relationship between of self-assessment and researcher evaluation of maternal scenario application competency of nurse-midwives using SBAR tool. Method: A quasi-experimental design was carried out with the application of pre- posttest for nurses-midwives’ knowledge regarding SBAR communication tool. The study is held in Al-Elwia maternity teaching hospital, Al –Karkh maternity hospital and Al-Yarmouk general teaching Hospital from 26/3/2017-to- 30/4/2018. The study aims to assess the Educational Program concerning Nurse- Midwives SBAR Tool Communication on Maternal Health Documentation at Maternal wards in Baghdad Maternity Hospitals and to assess the relationship between self-assessment and researcher evaluation of maternal scenario application competency of nurse-midwives using SBAR tool applying during fit time. The study sample consist of Non-probability (purposive) sample consisted of (84) nurse- midwives. The questionnaire comprised of demographic data, nurses- midwives knowledge of SBAR using (3) level Likert scale for assessment, with Cut –off point (2). Content validity was determined through (21) experts. ...............

NURSES’ SATISFACTION TOWARDS THE USAGE OF SBAR AS A COMMUNICATION TOOL FOR HANDOFF IN A PRIVATE HOSPITAL PENANG

Background: Handoff is an important communication process involving the exchange of patient information between healthcare workers. Situation, Background, Assessment and Recommendation (SBAR) is a standardised tool that is created to enhance the efficiency of communication thus giving rise to effective collaboration, increases patient satisfaction as well as patient outcome. Although, SBAR was initiated in this private hospital for almost a decade and reinforced in 2017, the overall acceptance and usage of SBAR reflect otherwise. Hence, the purpose of this study is to determine the nurses’ satisfaction towards the usage of SBAR as a communication tool and its association with socio-demographic variables. Methods: A cross-sectional descriptive study design was conducted with 234 nurses selected using a simple random sampling at a private hospital, Penang. A piloted and validated, Handover Evaluation Scale (HES) was used as the study tool. Result: Overall, nurses were satisfied with the use of SBAR (M = 68.9, SD = 11.94) and there was a significant association between gender and satisfaction of nurses towards usage of SBAR (t = 2.130, p < 0.05). Conclusion: Although the nurses were satisfied with the use of SBAR, there is a need to look into the reason for lack of satisfaction with its efficiency of implementation.

The effects of CPBL + SBAR teaching mode among the nursing students

ObjectiveTo investigate the effect of CPBL (Problem Based Learning on Case) combined with SBAR (Situation, Background, Assessment and Recommendation) mode in clinical teaching for nursing students. BackgroundClinical internship training is the key step for the nursing education. The clinical thinking ability of Chinese nurses is mostly at the middle or low level. To improve clinical thinking ability, especially critical thinking, is of great significance to the nursing practice education. Methods102 nursing students of the Third Xiangya Hospital, Central South University were selected as the participants from June 2018 to September 2019. We applied the CPBL + SBAR mode to the participants during the practice teaching, and conducted questionnaires and semi-structured interview pre- and post-intervention. ResultsAfter intervention, the nursing students' scores of critical thinking ability (311.47 ± 22.67) were higher than those before intervention (289.75 ± 19.94); the total score (69.84 ± 6.217) and scores in four dimensions of positive problem orientation (RPO), negative problem orientation (NPO), avoidance style (AS) and impulse neglect style (ICS) were all lower than that before intervention (75.53 ± 6.09); the score of rational problem solving (RPS) (18.38 ± 2.714) was higher comparing to the that of pre-intervention (17.11 ± 2.20); the difference was statistically significant (P < 0.05). The approval rate of nursing students to the positive effect of CPBL + SBAR teaching mode was from 78.43% to 93.13%. The semi-structured interview suggested that the model was worth promoting, but the implementation duration was limited. ConclusionCPBL + SBAR teaching mode could improve the nursing students' critical thinking and problem-solving ability. The nursing students and teachers' satisfaction to the new teaching mode was high.

The use of SBAR as a structured communication tool in the pediatric non-acute care setting: bridge or barrier for interprofessional collaboration?

ABSTRACT SBAR (Situation, Background, Assessment and Recommendation) is a structured method developed for communicating critical information that requires immediate action. In 2016 the SBAR tool was introduced at the Amalia Children’s Hospital in the Netherlands to improve communication between healthcare workers. Despite formal training and the introduction of aids to facilitate implementation, observed adherence to the tool was low. A qualitative study was undertaken to study the use of SBAR by pediatric residents and nurses in the non-acute clinical care setting of an academic children’s hospital. Semi-structured focus group sessions were conducted and qualitatively analyzed using a constructed coding template to search for facilitators and barriers in the use of SBAR by different professionals. We found professionals’ use of SBAR was influenced by departmental, cultural, and individual factors. Important themes for effective implementation and use of SBAR in an interprofessional setting, like situation dependency, learning climate and professional identity had not been addressed during the initial implementation. To facilitate SBAR’s use it is important to identify professionals’ needs to use the tool effectively, to take into account how tasks and responsibilities are perceived by different professions, and to stimulate interprofessional feedback and role modeling.

Evaluation of the Situation, Background, Assessment, and Recommendation Handover Tool in Improving Communication and Satisfaction Among Jordanian Nurses Working in Intensive Care Units.

The SBAR (situation, background, assessment, and recommendation) is a standardized handover tool that has been utilized in health care settings. It has positive impacts on staff communication and patient quality of care. In Jordan, few reports are available about handover tools' impacts. To evaluate the implementation of the SBAR among nurses in intensive care units (ICUs) in Jordan. A pretest-posttest quasi-experimental design was used. A convenience sample of 71 ICU nurses participated. The 43-item ICU physician-nurse questionnaire was used to measure SBAR effectiveness as measured by the following subscales: general relationship and communication, teamwork and leadership, and job satisfaction. There was a significant improvement in posttest knowledge scores and in "general relationships and communication" and "satisfaction" scores. There was a significant improvement in both "general relationships and communication" and "satisfaction" posttest scores compared with their pretest scores (t = 16.709, 2.656; P < .001, P < .01) consecutively. This study revealed a strong indicator to encourage the SBAR utilization among nurses in health care settings. The SBAR has a positive impact on enhancing communication between nurses and increasing their job satisfaction. Thus, the utilization of such a standardized tool that maintains and assures good communication relationships shall increase level of satisfaction. Future studies are recommended to provide further evidence on its feasibility and efficacy as compared with traditional handover tools and among different health care contexts.

Effects of SBAR model in nursing clinical teaching of Obstetrics and Gynecology Department

Objective To explore the effects of situation, background, assessment and recommendation (SBAR) model on communication skills and clinical practice abilities in nursing clinical teaching of Obstetrics and Gynecology Department so as to provide a basis for perfecting clinical nursing practice. Methods By convenience sampling, this study selected 31 intern nursing students in Obstetrics and Gynecology Department of Xuanwu Hospital, Capital Medical University from June 2017 to December 2017 in control group and 30 intern nursing students from June to December 2018 in observation group. Control group carried out the one-to-one teaching based on nursing intern outline of Obstetrics and Gynecology Department, especially paid attention to theoretical and skill training for intern nursing students. On the basis of that, observation group implemented clinical teaching with the SBAR model. The effects of teaching models of two groups in clinical teaching were evaluated with the score of clinical communication competence scale, inpatient satisfaction with nursing students and clinical practice performance. Results The clinical communication competence, inpatient satisfaction with nursing students and examination scores of nursing students in observation group after-department were higher than those in control group with statistical differences (P<0.05) . Conclusions SBAR model teaching is conducive to cultivating nursing students' clinical communication competence, improving their abilities to analyzing and solving problems in clinical practice. Key words: Obstetrics and gynecology department, hospital; Students, nursing; Internship; SBAR model; Clinical teaching; Communication skills

Improving the quality of handover: implementing SBAR.

Effective communication is essential in the provision of safe patient care. Use of structured communication tools, such as the Situation, Background, Assessment and Recommendation (SBAR) format of handover have been shown to improve patient safety, especially for telephonic handovers.1 SBAR has widely been recommended as a standardised method of handover.2,3 We undertook a quality improvement (QI) project to increase SBAR awareness across two wards in a district general hospital. This study describes the effect of our interventions and the challenges of implementing QI methodology to measuring safe communication and handover.

Implementation of an SBAR communication program based on experiential learning theory in a pediatric nursing practicum: A quasi-experimental study

BackgroundEffective communication by nurses is crucial to ensure patient safety. A structured communication program increases communication clarity, education satisfaction, and positivity during interprofessional collaboration among students. In an effort to facilitate effective communication between nurses and physicians, the well-known structured communication tool SBAR (Situation, Background, Assessment, and Recommendation) has been extensively used in clinical and educational settings. ObjectivesThe purpose of the study is to investigate the impact of an SBAR communication program on communication performance, perception, and practicum-related outcomes in senior-year nursing students. MethodThe study employed a non-equivalent control group quasi-experimental design and implemented the tool in the pediatric nursing practicum of a nursing school. The experimental group participated in a SBAR program, where role playing using SBAR techniques for different scenarios was used to improve practical communication among nursing students. The SBAR program was developed based on Kolb's Experiential Learning Theory. Communication performance was assessed via the SBAR communication tool and the communication clarity scale. Communication perception was measured by handover confidence level. Practicum-related outcomes of clinical practice self-efficacy, perceived nurse–physician collaboration, and practicum satisfaction, were also evaluated. ResultsThe experimental group demonstrated significantly higher SBAR communication (p < .001), communication clarity (p < .001), and handover confidence (p < .001) than the control group. Clinical practice self-efficacy, perceived nurse–physician collaboration, and practicum satisfaction did not differ. ConclusionsThe SBAR program in a pediatric nursing practicum improves SBAR communication, communication clarity, and perceived handover confidence in senior-year nursing students.

Calling for help: teaching medical students about situation, background, assessment and recommendation

To pilot a new tutorial to improve medical students’ confidence in using situation, background, assessment and recommendation (SBAR) for clinical communication. Over 3 months we facilitated high-fidelity simulation sessions for final year medical students. During this we observed that students struggled to give a good-quality handover. Colleagues across two sites reported similar observations when surveyed. We designed a 1-hour tutorial, to be delivered by two faculty members, to …

Using SBAR to Communicate with Policymakers

Nurses recognize and promote the importance of advocacy for nurses at all levels of practice. Despite increased involvement of nurses in policy arenas in recent years, existing evidence suggests a continued practice gap in nurse advocacy, particularly related to approaching national policy stakeholders. The reason for this gap are nurses’ perceived lack of personal free time to engage in policy activities and perceived lack of skill in communicating with policymakers. The situation, background, assessment and recommendation (SBAR) situational briefing tool is an evidence-based communication tool familiar to many nurses. The purpose of this article is to discuss nurse advocacy and to examine SBAR as a means by which nurses can effectively and confidently interact with policymakers. The author discusses the history of SBAR communication, provides an exemplar of SBAR application in policy settings, and offers future research and educational implications. Using SBAR when engaging in activities with policy makers may help nurses overcome perceived barriers and more effectively engage with key policy stakeholders.

GW29-e0801 The application of standardized SBAR communication model of acute heart failure in nursing students teaching

To explore the application and effect of the standardized SBAR (Situation, Background, Assessment, and Recommendation) communication mode of acute heart failure in clinical nursing student rounds. Establishing standardized SBAR report template for acute heart failurebased on evidence-based method

Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review

ObjectivesCommunication breakdown is one of the main causes of adverse events in clinical routine, particularly in handover situations. The communication tool SBAR (situation, background, assessment and recommendation) was developed to...

Interprofessional Pharmacokinetics Simulation: Pharmacy and Nursing Students' Perceptions.

Interprofessional practice between pharmacists and nurses can involve pharmacokinetic dosing of medications in a hospital setting. This study describes student perceptions of an interprofessional collaboration pharmacokinetics simulation on the Interprofessional Education Collaborative (IPEC) 2016 Core Competencies. The investigators developed a simulation activity for senior undergraduate nursing and second-year pharmacy students. Nursing and pharmacy students (n = 54, 91 respectively) participated in the simulation using medium-fidelity manikins. Each case represented a pharmacokinetic dosing consult (vancomycin, tobramycin, phenytoin, theophylline, or lidocaine). Nursing students completed head-to-toe assessment and pharmacy students gathered necessary information and calculated empiric and adjusted doses. Students communicated using SBAR (Situation, Background, Assessment, and Recommendation). Students participated in debrief sessions and completed an IRB-approved online survey. Themes from survey responses revealed meaningful perceptions in all IPEC competencies as well as themes of safety, advocacy, appreciation, and areas for improvement. Students reported learning effectively from the simulation experience. Few studies relate to this type of interprofessional education experience and this study begins to explore student perceptions of interprofessional education (IPE) in a health sciences clinical context through simulation. This real-world application of nursing and pharmacy interprofessional collaboration can positively affect patient-centered outcomes and safety.

The performance improvement of look-alike sound-alike drug pre-dispensing

Medical dispensing errors are common and classic human errors in the hospitals. Look-alike, Sound-alike (LASA) drug is one of the main issues in pre-dispensing and dispensing processes. The data in this study were observed from one middle size hospital in Thailand. In 2017, there were two months that the medication errors KPI (0.065 and 0.061) were greater than the accepted error threshold (0.06). The SBAR (Situation, Background, Assessment, and Recommendation) solution and HOSxP software were applied for three months in the pre-dispensing process to reduce the medical dispensing errors. The results showed that the medication errors KPI (0.04, 0.03, and 0.02, respectively) were reduced dramatically. Therefore, implementation of the SBAR and HOSxP software is recommended as a fast and easy solution for medical dispensing errors.

Online Course Improves Nurses’ Knowledge of Antimicrobial Stewardship

Nurses who completed an online training course in antimicrobial stewardship showed increased knowledge about infections in long-term care residents and understanding of the nursing staff’s role in infection control, a small study has found. “Online education targeting nurses and their role in antimicrobial stewardship could be a useful and practical component of comprehensive antimicrobial stewardship programs in nursing homes,” according to study author Robin L.P. Jump, MD, PhD, an assistant professor of medicine in the division of infectious diseases and HIV medicine at Case Western Reserve University, and her coauthors [Am J Infect Control, Feb 8, 2017; doi:10.1016/j.ajic.2017.01.002]. For the study, a free online course covering the fundamentals of antimicrobial stewardship was completed by 103 nurses. The course takers were nearly all women, two-thirds of whom were registered nurses; the rest were largely licensed practicing nurses. Nearly two-thirds worked at community-based nursing home facilities, and well over half had been in the field for more than 10 years. The course comprised six modules, 30 minutes each, covering essential topics in antimicrobial stewardship in long-term care settings: igns and symptoms of infection in older adults; differentiating urinary tract infections from asymptomatic bacteriuria; recognition and evaluation of upper respiratory tract infections, bronchitis, and pneumonia; appropriate application of transmission-based precautions; proper collection of samples for microbiologic culture; and improving communication with providers using SBAR (Situation, Background, Assessment, and Recommendation). The surveys before and after the course of the participants’ attitudes, beliefs, and knowledge showed they gained confidence in various subjects, particularly how to differentiate urinary tract infections from asymptomatic bacteriuria, and upper respiratory tract infections, bronchitis, and pneumonia. In addition, the mean survey scores on the nurses’ understanding of how their attitudes and interactions with residents and residents’ families directly affected antimicrobial stewardship increased significantly after the course’s completion. Whether a nurse knew the baseline status of a resident and that resident’s antibiotic exposure rose in importance to the course takers, according to the surveys: from a Likert scale score of 3.8 out of 5 to 4.5 for both items. Most respondents supported the strategy of “watchful waiting” to avoid antibiotic prescribing; scores remained constant at 4.1 out of 5. Also unchanged across the pre-course and post-course surveys was the idea that “only vulnerable people acquire multidrug resistant pathogens,” which remained constant at 20 out of 5. The number of correctly answered knowledge-assessment survey questions increased from 75% (9.0 of 12 questions) to 86% (10.4 of 12 questions) across the course takers, especially around recognizing fever in older adults and in catheter-associated urinary tract infection prevention. A knowledge gap persisted, however, about how to properly collect samples for a microbiologic culture. Dr. Jump and her colleagues wrote that as regulatory pressures mount for improved antibiotic stewardship, “nurses will likely become integral members of multidisciplinary antimicrobial stewardship teams. Antimicrobial stewardship–focused education may increase nurses’ confidence, empower them to help effect changes necessary to reduce unnecessary antibiotic prescriptions, and improve the overall care and safety of nursing home residents.” Helen Jones is a NJ-based freelance writer.