Use Of SBAR Research Articles

Using SBAR in psychiatry: findings from two london hospitals

AimsWe aimed to evaluate the use of the Situation, Background, Assessment and Recommendation communication tool (SBAR) at two large psychiatric hospitals, in order to design new approaches to teach and reinforce its sustained use. In doing so we hope to improve communication, staff experience and outcomes for patients.We hypothesised that use prior to intervention would be low and attitudes inconsistent between teams and objective data.BackgroundSBAR is a communication tool developed to accurately refer information with improved outcomes within the NHS. Within psychiatry there is evidence of relatively poor care of medical problems leading to adverse outcomes in a group more susceptible to multiple physical illnesses. The reasons for this include a cultural ethos of learned helplessness in staff and lack of medical knowledge.The use of SBAR is likely to overcome these issues.MethodSurveys were presented to doctors and nurses staff at two Psychiatric Hospitals, Chase Farm and Edgeware. Inclusion in the survey was voluntary and anonymous. Questions elucidated topics ranging from awareness of SBAR through to its use and benefits.Objective data were also collected, looking at handover gathered during the survey period. This was collected via phone from the duty physician over a five-day period, twice-daily. Qualitative data on handover content was collected at CFH.Audit standards around knowledge, use and outcomes were set. Data were collected and analysed in house.ResultThe data (n23) showed that most nurses reported awareness (86.96%) ease of use (86.96%) actual use (60.87%) efficacy in communication (78.26%) value in understanding patients (78.26%) and agreement with mandatory use (78.26%.)Doctor reports (n14) showed that although 100% were aware of SBAR, no respondents thought nurse-led communication was adequate, or that SBAR was used. The majority thought that mandatory SBAR use would improve communication (92.86%) and patient care (100%)Objective data (pooled) of referrals showed that on 6.52% used SBAR. Qualitative data showed that handover was often inaccurate, lacking in information and unsafe. Suggestions for teaching included written or video media, or taught classes.All audit standards were failed.ConclusionSBAR is an effective tool for improving communication and patient outcomes, and is well perceived by the MDT. However, it is poorly used with psychiatry leading to adverse outcomes. Reported use is undermined by objective data. Its mandatory use is well supported and new teaching initiatives are thus being designed to remedy this and improve client experience.

Devising a protocol for calling 999 from a dental practice and using SBAR to ensure effective communication and handover.

If a medical emergency occurs in a dental practice and it is necessary to call 999 for an ambulance, it is important to ensure that it is done safely and proficiently. It is particularly important to ensure effective communication with the ambulance service, ideally using the SBAR communication tool both when calling 999 and also during handover to the paramedics once they arrive. These arrangements still need to be followed even during the pandemic crisis in which we we are all. This article outlines the procedure for calling 999 from a dental practice and discusses the use of SBAR to ensure effective communication with the ambulance service.

SBAR as a Standardized Communication Tool for Medical Laboratory Science Students.

Laboratory professionals must communicate effectively on an interprofessional team. It is the responsibility of Medical Laboratory Science (MLS) programs to teach communication. The structured communication tool Situation, Background, Assessment, and Recommendation (SBAR) is one way to promote effective communication. Students participated in a case-based simulation activity on the importance of teamwork/communication and the use of SBAR and completed a pre/post survey on communicating interprofessionally. Students reported increased confidence and competence with interprofessional communication after the activity with 4 of 5 questions demonstrating a statistically significant increase in scores post SBAR instruction. Our study demonstrates that SBAR is a suitable communication tool that can be used to increase our MLS students' confidence and competency in interprofessional communication. Educators should use this communication tool to empower MLS students to be effective members of the healthcare team.

Improving Education and Communication in an Assisted Living Facility to Reduce Avoidable Emergency Department Transfers: A Quality Improvement Project.

The purpose of the current project was to determine the effectiveness of training and communication tools used as intervention strategies to reduce unnecessary emergency department transfers of assisted living facility (ALF) residents. Two communication protocols (SBAR and STOP and WATCH) were introduced to standardize clinical communication among licensed practical nurses (LPNs) and clinical providers. Twenty-nine LPNs working in an ALF with 172 units were recruited. LPNs participated in an intervention intended to improve knowledge on geriatric syndromes. Pre- and postintervention testing revealed improved LPN knowledge of geriatric syndromes. A satisfaction survey indicated positive LPN acceptance of the standardized communication tools. Through daily auditing of charts, adherence with use of the SBAR tool was 87%. This evidence-based, educational intervention project aimed to improve nursing staff geriatric knowledge, monitor nurse adherence to using the SBAR and STOP and WATCH tools, and assess overall satisfaction with use of SBAR. [Journal of Gerontological Nursing, 45(5), 23-29.].

Bringing the R Back to SBAR: A Focused Heart Failure SBAR Tool

This article describes a quality improvement (QI) project implemented in a home health setting among a population of patients with heart failure (HF). It was discovered there was a lack of nurse-led recommendations and ineffective use of the situation, background, assessment, and recommendations (SBAR) tool among home health nurse when communicating with providers about HF patients. Therefore, the QI project focused on creating and implementing a focused HF SBAR tool and a self-care patient checklist to be utilized by all home health nurses for all visits with HF patients. The focused HF tool was created and laminated and became part of home health nurse’s identification badges. The implementation phase took place over a 60-day time period. Following implementation, outcomes were measured and demonstrated an increased use of SBAR, and an increase in nurse-led recommendations documented. In addition, there was a decrease in acute hospitalizations for HF among home health patients. Furthermore, there was an increase in nurse-led interventions implemented in the home along with an increase of referrals to physical therapy (PT) and occupational therapy (OT). The educational session was well-received and prompted a practice change in the delivery of future continuing education content. Finally, organizational leadership reported increased confidence and improved interprofessional communication among home health nurses and providers.

Improving the practice of handover for psychiatric inpatient nursing staff

The aim of this project was to embed SBAR as a communication framework into inpatient point of care nurses handover practices on 27 inpatient psychiatric units, and to ensure that the information given/received provided staff with the confidence to provide safe patient care. A plan-do-study-act quality improvement framework was used to improve the adoption of SBAR in practice. Resources were developed that were relevant to the psychiatric setting; staff were educated, audits and a survey were completed. The use of SBAR in practice increased from 4% pre intervention to 79% post intervention. Satisfaction with the information received during handover increased from 34% to 41%. Findings of this project demonstrate that the standardization of handover practices and the implementation of a consistent communication framework across the organization can improve the effectiveness of shift handover, increase staff satisfaction, and improve safety of both staff and patients.

Nurses’ perceptions regarding using the SBAR tool for handoff communication in a tertiary cancer center in Qatar

Background : Communication failure has been reported in the literature as the primary source of medical errors and patient harm. Among various methods of handoff communication, Situation, Background, Assessment, and Recommendation (SBAR) is a reliable and efficient framework that nurses worldwide use. The investigators sought to assess the perceptions of nurses with regard to using the SBAR tool for hand-off communication at a cancer hospital in Qatar. Methods : A cross-sectional descriptive study was carried out to assess perceptions regarding the use of SBAR among 117 staff nurses working in inpatient units of National Center for Cancer Care and Research (NCCCR). A handover evaluation tool was used, enabling nurses to self-report their perceptions. Results : The majority of staff nurses opined that SBAR followed a logical sequence, with a reduction in communication errors after its use. Also, 53.9% of the nurses reported that they would always recommend the SBAR framework in other areas. The majority (87.3%) of the nurses had good perceptions regarding the use of the SBAR framework, and none of them had poor perceptions regarding the same. The mean duration of handovers reduced after their use of SBAR. There was no association between perceptions and demographic variables. Conclusions : SBAR is safe and efficient, and it can be recommended for all healthcare settings. The SBAR communication technique provides an organized logical sequence and improved communication that has been proved to ensure patient safety.

Small Scale, Low Resource Options for Introducing Clinical Laboratory Science Students to Interprofessional Simulation

1. Michelle R. Brown, MS, MLS(ASCP)CMSBBCM[⇑][1] 1. University of Alabama at Birmingham, School of Health Professions, Department of Clinical and Diagnostic Sciences, Birmingham, AL 2. Kristopher Maday, MS, PA-C, CNSC 1. University of Alabama at Birmingham, Physician Assistant Studies, Birmingham, AL 3. John Hurt, MS, PA-C 1. University of Alabama at Birmingham, Physician Assistant Studies, Birmingham, AL 1. Address for Correspondence: Michelle R. Brown, MS, MLS(ASCP)CMSBBCM, University of Alabama at Birmingham, Assistant Professor, School of Health Professions, Department of Clinical and Diagnostic Sciences, 1705 University Blvd, SHPB 474, Birmingham, AL 35294 1. Describe the use of SBAR as a communication tool. 2. Identify the phrases associated with the term CUS. 3. Construct a classroom-based interprofessional simulation for clinical laboratory science students. INTRODUCTION In the report, Health Professions Education: A Bridge to Quality, the Institutes of Medicine (IOM) has detailed a vision for preparing healthcare professionals.1 A focal point within this vision is teaching students to work in interdisciplinary teams. In a separate report, Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes, the IOM calls for an alignment of education and healthcare delivery systems.2 The Clinical Laboratory Science (CLS) education community needs to readily embrace the IOMs vision and enthusiastically answer the call with innovative educational methods such as interprofessional simulation (IP). Some CLS programs are already considering interprofessional simulation, but may not have an existing simulation infrastructure or financial support from administration. Other programs have a laboratory with instrumentation, but have not yet made the leap from simulating a “day in the lab” with CLS students to including students from professions outside the laboratory to provide comprehensive situations that more closely mimic working in a healthcare environment. This manuscript offers small scale, low resource options to help a CLS program include IP simulation as an innovative educational method to teach interprofessional communication and teamwork. Getting Started: Know the Fundamentals While high fidelity mannequins, patient rooms, and instrumentation provide an authentic environment, they are not required to offer a quality IP experience. There are, however, fundamentals that remain the same whether designing intricate scenarios for students from several professional programs or simple scenarios with students from only two professions. This includes the alignment of content knowledge between students… ABBREVIATIONS: IOM – Institutes of Medicine, CLS – Clinical laboratory scientist, IP - Interprofessional, SBAR – Situation, Background, Assessment, Recommendation/request, Team STEPPS - Team Strategies and Tools to Enhance Performance and Patient Safety, APP – Advanced practice provider, WHO – World Health Organization, CUS – Concerned, Uncomfortable, Safety issue, SP – Simulated patient, PA – Physician assistant, UAB – University of Alabama at Birmingham 1. Describe the use of SBAR as a communication tool. 2. Identify the phrases associated with the term CUS. 3. Construct a classroom-based interprofessional simulation for clinical laboratory science students. [1]: #corresp-1

Examining the feasibility and utility of an SBAR protocol in long-term care

Ineffective nurse–physician communication in the nursing home setting adversely affects resident care as well as the work environment for both nurses and physicians. Using a repeated measures design, this quality improvement project evaluated the influence of SBAR (Situation; Background of the change; Assessment or appearance; and Request for action) protocol and training on nurse communication with medical providers, as perceived by nurses and physicians, using a pre–post questionnaire. The majority (87.5%) of nurses respondents found the tool useful to organize information and provide cues on what to communicate to medical providers. Limitations expressed by some nurses included the time to complete the tool, and communication barriers not corrected by the SBAR tool. Project findings, including reported physician satisfaction, support the use of SBAR to address both issues of complete documentation and time constraints.

Implementing SBAR Across a Large Multihospital Health System

Communication problems among health care personnel during critical clinical situations can jeopardize patient safety. SBAR, a structured-communication technique, has been adapted from aviation and the military as a strategy for clear communication based on a statement of the situation, background, assessment, and recommendations related to a critical issue. Nurses' use of SBAR and physician perception of communication quality after SBAR implementation was assessed at a 13-hospital health care system. Baylor Health Care System initiated a campaign to implement SBAR and train staff in SBAR techniques across its hospitals. Nurse surveys and physician audits were conducted. Of 156 nurses interviewed, 152 (97.4%) had been educated about SBAR, and 91 (58.3%) used SBAR for critical communication. Of 84 nurses whose proficiency with SBAR was assessed, 72.6% demonstrated good or high proficiency. Of the 155 physicians who responded to the physician survey, 121 (78.1%) said that the last report they received was adequate to make clinical decisions. Of the 27 who indicated that the last report was not adequate to make clinical decisions, 25 (92.6%) had not received the report in SBAR format. SBAR was generally well understood. Challenges included inconsistent uptake across facilities, lack of physician education about SBAR, and a tendency to view SBAR as a document rather than a verbal technique. Future research will address the need for refresher education with nurses after initial SBAR education, the need for formal physician education about SBAR use, and the possibility of conducting annual competency validation of the utilization of SBAR. Research should also examine the effect of SBAR on quality of care and patient outcomes in controlled trials.

Implementation and evaluation of the sbar tool in the communication between medical staff in obstetrics

BackgroundA key feature in patient safety is clear communication. In recent years the SBAR tool (situation, background, assessment and recommendation) has been advocated as a means of standardising communication when...

Significantly improving the efficiency of communication in paediatrics

IntroductionImproving efficiency in healthcare delivery while maintaining patient safety is central to providing high quality patient care, improved patient satisfaction and creates a culture of improved training for future paediatricians....