Raising the SBAR: How better communication improves patient outcomes

Albert Einstein Healthcare Network in Philadelphia, PA, USA.
Nursing Management 04/2008; 38(3):41-3. DOI: 10.1097/01.NURSE.0000312625.74434.e8
Source: PubMed
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    • "In this way, SBAR ''allows for an easy and focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety'' (Kaiser Permanente, 2010). Because of its preliminary success, SBAR is becoming more widely adopted at hospitals across the United States, especially in acute care situations (Pope et al., 2009). "
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    ABSTRACT: Communication errors have grave consequences in health care settings. The situation-background-assessment-recommendation (SBAR) protocol has been theorized to improve communication by creating a common language between nurses and physicians in acute care situations. This practice is gaining acceptance across the health care field. However, as yet, there has been little investigation of the ways in which SBAR may have an impact on how health care professionals operate beyond the creation of a common language. The purposes of the study were to explore the implementation of the SBAR protocol and investigate the potential impact of SBAR on the day-to-day experiences of nurses. We performed a qualitative case study of 2 hospitals that were implementing the SBAR protocol. We collected data from 80 semistructured interviews with nurses, nurse manager, and physicians; observation of nursing and other hospital activities; and documents that pertained to the implementation of the SBAR protocol. Data were analyzed using a thematic approach. Our analysis revealed 4 dimensions of impact that SBAR has beyond its use as a communication tool: schema formation, development of legitimacy, development of social capital, and reinforcement of dominant logics. The results indicate that SBAR may function as more than a tool to standardize communication among nurses and physicians. Rather, the findings indicate that SBAR may aid in schema development that allows rapid decision making by nurses, provide social capital and legitimacy for less-tenured nurses, and reinforce a move toward standardization in the nursing profession. Our findings further suggest that standardized protocols such as SBAR may be a cost-effective method for hospital managers and administrators to accelerate the socialization of nurses, particularly new hires.
    Health care management review 06/2011; 37(1):88-97. DOI:10.1097/HMR.0b013e31821fa503 · 1.30 Impact Factor
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    • "ISBAR, an acronym for Introduction , Situation, Background, Assessment, Recommendation is a framework for structured communication (Table 2). Originating as SBAR (Haig et al. 2006; Manning 2006) and enhanced by Jansky & Zafi (2007), the tool can be useful for nurses as a means of communicating with physicians about the change in a patient's status (Pope et al. 2008) and prompts the initiator to introduce themselves, state the current situation, give relevant background, state assessment findings and recommendations in any situation. It has recently been validated in Australia as an effective way to improve the clarity and content of clinically based communication (Marshall et al. 2009). "
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    ABSTRACT: Nurses and doctors undertake segregated and distinct preparation for clinical practice, yet are expected to communicate effectively with each other in the workplace. Most healthcare facilities have policies relating to written communication, but guidelines for verbal communication, which is used most in times of uncertainty and urgency, are generally less regulated. Poor communication and communication overload are shown to have a direct correlation with patient outcomes, adverse events and stressors among healthcare professionals. We suggest a guide for more effective verbal communication between nurses and doctors. We perform an integrated review of the extensive literature that identifies specific problems that contribute to ineffective communication between a doctor and nurse. We discuss these in five themes in the modern clinical context including intensification of workload, workforce mobility, differing perceptions, language use and heuristics. To combat these, we provide a four point practical guide to arm the nurse clinician with effective tools to ensure a satisfactory exchange of information in the context of patient advocacy. The guide assists in overcoming the discussed barriers by creating a premise for fostering communication, understanding each clinician's information needs in a mutually respectful manner, especially in the context of uncertainty. We recommend that a shared mental model regarding communication in health be adopted at tertiary institutions offering pre-registration nursing and medical training and techniques and be woven into respective curriculum design.
    International Nursing Review 03/2011; 58(1):13-20. DOI:10.1111/j.1466-7657.2010.00847.x · 0.95 Impact Factor
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    ABSTRACT: Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented.
    International Journal of Nursing Education Scholarship 02/2008; 5(1):Article40. DOI:10.2202/1548-923X.1647
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