ArticleLiterature Review

The SBAR Communication Technique Teaching Nursing Students Professional Communication Skills

July 2009
Nurse Educator 34(4):176-80

Source
PubMed

Authors:

Ball State University

The Joint Commission and Institute for Healthcare Improvement have mandated healthcare organizations to improve professional communication. Nursing students lack experience in communicating with physicians. As a result, recent graduates may not be prepared to meet the demands of professional communication to ensure patient safety. The authors discuss the SBAR (situation, background, assessment, recommendations) communication technique implemented during a 2-day simulation exercise that provided an organized logical sequence and improved communication and prepared graduates for transition to clinical practice.

Ibero-American Consensus on Communication Skills for Nursing Degree students

Article

Full-text available

May 2022

Objective: as a health care profession focused on caring for people, Nursing requires sound communication skills. Based on an international expert consensus, a proposal on learning outcomes in clinical communication for undergraduate Nursing education curricula in Spanish speaking countries is presented. Method: a steering committee, consisting of 5 nurses and experts in communication in health care sciences, drew up the first list of communication skills specific to the Nursing degree. Their proposal was reviewed and improved by a committee of 7 international scientific advisers. 70 experts from 14 countries were selected using a snowball sampling procedure and invited to participate in a distance modified Delphi consensus process in two survey rounds. Statistical analysis was carried out to establish the final consensus level for each item. Results: a questionnaire with 68 learning outcomes in clinical communications was submitted for panel assessment. In the first Delphi round, the panel reached a statistical consensus on all the items assessed. There was no need for a second round to reconcile positions. Conclusion: an academic proposal, approved by a high level of international consensus, is presented to guide and unify the learning outcomes on the clinical communication curriculum for undergraduate Nursing studies in Spanish speaking countries.

Consenso Iberoamericano sobre Habilidades de Comunicación para Estudiantes de Grado de Enfermería

Article

Full-text available

May 2022

Resumen Objetivo: en su carácter de profesión de atención de la salud enfocada en cuidar a las personas, la Enfermería requiere habilidades de comunicación sólidas. Sobre la base de un consenso internacional de expertos, se presenta una propuesta sobre resultados de aprendizaje en la comunicación clínica para planes de estudio de las carreras de grado de Enfermería en países de habla hispana. Método: un comité orientador, compuesto por 5 enfermeros y expertos en comunicación en ciencias de atención de la salud, elaboró la primera lista de habilidades de comunicación específicas para la carrera de Enfermería. Un comité de 7 asesores científicos internacionales revisó y mejoró dicha propuesta. Se seleccionó a 70 expertos de 14 países a través del procedimiento de muestreo “bola de nieve”, y se los invitó a participar en un proceso de consenso Delphi modificado a distancia en dos rondas de encuesta. Se realizó un análisis estadístico para establecer el nivel de consenso final correspondiente a cada ítem. Resultados: se presentó un cuestionario con 68 resultados de aprendizaje en comunicaciones clínicas para que lo evaluara el panel. En la primera ronda Delphi, el panel llegó a un consenso estadístico en todos los ítems evaluados. No fue necesaria una segunda ronda para conciliar posiciones. Conclusión: se presenta una propuesta académica, aprobada con un elevado nivel de consenso internacional, a fin de orientar y unificar los resultados de aprendizaje en los planes de estudio sobre comunicación clínica para carreras de grado de Enfermería en países de habla hispana.

Ibero-American Consensus on Communication Skills for Nursing Degree students

Article

Full-text available

May 2022

Effects of a stepwise handovers ISBARQ programme among nursing college students

Article

Full-text available

Jun 2020

Background Due to a lack of standardized guidelines, it is necessary to verify the effectiveness of educational programmes for nursing students' systematic handover training. Aims This study aimed to develop a stepwise nursing handover programme and to examine its effects on awareness of handover Situation, Background, Assessment, Recommendation, communication self‐efficacy and satisfaction with handover education. Design This was a single‐group repeated measures ANOVA study. Methods This study was conducted in a nursing department, using a convenience sample of 25 senior nursing students from April 2 to June 22, 2018. The programme was divided into lectures, scenario role‐playing and nursing case role‐playing. The research questions were analysed using repeated measures ANOVA. Results Awareness of handover Situation, Background, Assessment, Recommendation, communication self‐efficacy and satisfaction with handover education gradually increased after each step of the programme. The stepwise nursing handover programme, progressing from low to high levels of learning, can be used to improve the nursing handover system and handover communication ability.

Beating the urban heat: Situation, background, impacts and the way forward in China

Article

Full-text available

Mar 2022
RENEW SUST ENERG REV

This paper reviews urban heat (UrHT) challenges following the SBAR (situation, background, assessment and recommendation) framework. The results indicate that heatwaves become more frequent, lasting and intense, especially after 1990s. Above 1960s level, heatwaves across China doubled in both magnitude and frequency by 2018. Jianghuai and Southern China underwent the largest magnitude and most widespread increases. Under 1.5°C warming limit, the average heatwave days and duration across China will increase by 10.8 days and 3.9 days. Drought–heatwave co–occurrence is increasingly frequent at 7–11%/decade (from 1961 to 2018) and the co–occurrence leads to more intense heatwaves. UHIs are a common issue for almost all Chinese cities and UHIs have been aggravating annually. Daytime UHIs peak in summer, indicating the synergies with heatwaves. The synergies are prominent in southeastern cities for strong summer daytime UHIs in eastern cities and intense heatwaves in southern regions. UrHTs have not been recognised and there are no dedicated/mandatory plans. Mega–challenges of climate change, rapid urbanisation, carbon– and labour–intensive economic growth and demographic changes can potentially lock China into UrHT challenges. Addressing UrHT challenges is urgent in China not only for environmental, ecosystem, social and health consequences, but also for economic impacts relevant to labour, capital, and goods or services. Efforts are suggested in technical improvement, policy formulation, social participation, economic investment and co-benefit approach recognition. Overall, this paper provides a comprehensive understanding of heat–related challenges in China and can guide the creation of cool cities and communities in practice.

Comparison of an In-Person versus a Virtual Interprofessional Education Activity Focused on Professional Communication

Article

Full-text available

Jun 2021

Early provision of interprofessional education (IPE) is imperative to ensure effective communication between healthcare professionals. However, there are several barriers to offering adequate IPE, including space restrictions and lack of human resources, prompting exploration of alternative modalities. In 2019, an IPE activity was offered in person with 213 pharmacy and 45 physician assistant (PA) students participating in one-on-one team huddles focusing on managing an acutely ill patient. In 2020, the same IPE activity, including 194 pharmacy and 45 PA students, was offered virtually. Peer evaluations, an attitudes survey, and confidence surveys were administered to evaluate the impact of the IPE activity. A student t-test and descriptive statistics were utilized to analyze the data. On average, PA students in the virtual group rated their peers higher than PA students in the in-person group, with little difference in the pharmacy peer evaluation of their PA partner. Ninety percent of pharmacy students and 91% of PA students in the virtual group felt that “they learned something new regarding therapeutic management” from their partner versus 84% of pharmacy and 81% of PA students in the in-person group. In conclusion, using a virtual modality for a communications-focused IPE was not detrimental to student attitudes and did not adversely affect peer perceptions.

Nursing Students’ Experiences with Computer Simulation-Based Communication Education

Article

Full-text available

Mar 2021
Int J Environ Res Publ Health

Simulation-based communication education has improved nursing students’ communication knowledge and skills. However, communication patterns that students commonly exhibit in simulated situations and students’ responses to specific clinical situations have not been systematically examined. The specific aims of the present study were (1) to identify non-therapeutic communication patterns that nursing students exhibit in simulated situations in the computer simulation-based education (ComEd) program, and (2) explore students’ responses to challenging clinical situations. This study used a mixed-method research design and a convenience sampling method to recruit participants. Frequency analysis and a conventional content analysis method were used to analyze answers provided by participants. A total of 66 students from four Korean nursing schools participated in the study. “False reassurance” was found to be the most common non-therapeutic communication pattern used by nursing students. Nursing students had difficulty in clinical situations such as reporting a patient’s condition to a doctor, communicating with a patient and perform basic nursing skills at the same time, and managing conflicts between patients. Technology-based communication simulation programs, which reflect various clinical situations, are considered a new alternative that can supplement the limitations of clinical practicum and improve the quality of nursing education.

Development and Evaluation of a Nurse Practitioner Huddles Toolkit for Long Term Care Homes

Article

Full-text available

Dec 2023
Can J Aging

Long-term care homes (LTCHs) were disproportionately affected by the coronavirus disease (COVID-19) pandemic, creating stressful circumstances for LTCH employees, residents, and their care partners. Team huddles may improve staff outcomes and enable a supportive climate. Nurse practitioners (NPs) have a multifaceted role in LTCHs, including facilitating implementation of new practices. Informed by a community-based participatory approach to research, this mixed-methods study aimed to develop and evaluate a toolkit for implementing NP-led huddles in an LTCH. The toolkit consists of two sections. Section one describes the huddles’ purpose and implementation strategies. Section two contains six scripts to guide huddle discussions. Acceptability of the intervention was evaluated using a quantitative measure (Treatment Acceptability Questionnaire) and through qualitative interviews with huddle participants. Descriptive statistics and manifest content analysis were used to analyse quantitative and qualitative data. The project team rated the toolkit as acceptable. Qualitative findings provided evidence on design quality, limitations, and recommendations for future huddles.

Effectiveness of SBAR-based simulation programs for nursing students: a systematic review

Article

Full-text available

Jul 2023
BMC Med Educ

Background Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students. Methods A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project “Quality Assessment Tool for Quantitative Studies” was used to assess the quality of the included studies. Results Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students’ behaviors related to patient safety. Conclusions This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.

Korean nurses’ perception and performance on communication with physicians in clinical deterioration

Article

Full-text available

Sep 2022
MEDICINE

Effective communication between nurses and physicians is necessary for prompt and accurate responses in clinical deterioration. This study aimed to examine nurses’ perception and performance of communication with physicians in clinical deterioration situations in the ward. A descriptive research design with a survey of 250 ward nurses working in 2 tertiary hospitals was used. Regarding communication with the physician, nurses’ perception was highest for timeliness, followed by accuracy, understanding, satisfaction, and openness, and their performance was highest for preparation, followed by situation, background, assessment, and recommendation. It is suggested that proactive activities for improving openness, accuracy, satisfaction, and mutual understanding between physicians and nurses are required for patient safety. Additionally, the performance for assessment and recommendations should be improved. Education programs for nurses and physicians should be developed and applied to clinical practice to promote understanding and trust in interprofessional communication.

Interdisciplinary staff perceptions of advance care planning in long-term care homes: a qualitative study

Article

Full-text available

Jul 2022
BMC Palliat Care

Background Residents living in long-term care homes (LTCH) have complex care needs, multiple chronic conditions, increasing frailty and cognitive impairment. A palliative approach that incorporates advance care planning (ACP) should be integrated with chronic disease management, yet it is not a norm in most LTCHs. Despite its growing need, there remains a lack of staff engagement in the ACP process. Objectives The aim of this study was to explore the perceptions and experiences of interdisciplinary staff related to the practice of ACP in LTCHs. Methods This study is part of a larger Canadian project, iCAN ACP, that aims to increase uptake, and access to ACP for older Canadians living with frailty. An exploratory qualitative design using an interpretive descriptive approach was employed utilizing focus groups and semi-structured interviews with staff from four LTCHs in Ontario, Canada. Findings There were 98 participants, including nurses ( n = 36), physicians ( n = 4), personal support workers ( n = 34), support staff ( n = 23), and a public guardian ( n = 1). Three common themes and nine subthemes were derived: a) ongoing nature of ACP; b) complexities around ACP conversations; and c) aspirations for ACP becoming a standard of care in LTCHs. Discussion The findings of this study provide important contributions to our understanding of the complexities surrounding ACP implementation as a standard of practice in LTCHs. One of the critical findings relates to a lack of ACP conversations prior to admission in the LTCHs, by which time many residents may have already lost cognitive abilities to engage in these discussions. The hierarchical nature of LTCH staffing also serves as a barrier to the interdisciplinary collaboration required for a successful implementation of ACP initiatives. Participants within our study expressed support for ACP communication and the need for open lines of formal and informal interdisciplinary communication. There is a need for revitalizing care in LTCHs through interdisciplinary care practices, clarification of role descriptions, optimized staffing, capacity building of each category of staff and commitment from the LTCH leadership for such care. Conclusion The findings build on a growing body of research illustrating the need to improve staff engagement in ACP communication in LTCHs.

Ward Nurses’ Perception and Performance on Communication with Physician in Clinical Deterioration in Korea: A cross-sectional study

Preprint

Full-text available

Mar 2022

Background Effective communication between nurses and physicians is necessary for prompt and accurate response in clinical deterioration. Purpose This study aimed to examine nurses’ perception and performance on communication with physicians in clinical deterioration situations in the ward. Method A descriptive research design with a survey of 250 ward nurses working in two tertiary hospitals. Findings : On communication with the physician, nurses’ perception was highest for the timeliness, followed by accuracy, understanding, satisfaction, and openness, and their performance was highest for preparation, followed by the situation, background, assessment, and recommendation. Conclusions It is suggested that proactive activities for improving openness, accuracy, satisfaction, and mutual understanding between physicians and nurses are required for patient safety. Additionally, the performance for assessment and recommendations should be improved. Education programs for nurses and physicians should be developed and applied to clinical practice to promote understanding and trust in interprofessional communication.

Communication Skills Profile of Elementary Teacher Education Students in STEM-based Natural Science Online Learning

Article

Full-text available

Dec 2021

This study aimed to determine the communication skill profile of Elementary Teacher Education (ETE) students enrolled in natural science online learning-based STEM. Pre-experimental research with a one-shot case study design was used in this study. The study's sample consisted of 25 ETE students from a university in Cimahi. Observation and documentation were the techniques used in this study. The paired sample t-test was used to analyze the data. The descriptive analysis and hypothesis testing with the t-test were used to check the data validity. The findings of this study revealed that (1) there is an effect of STEM-based online science learning on ETE students' communication skills, (2) that most students are still in the Intermediate category for written communication and "does not meet the Standards" for oral communication skills, and (3) that students' communication skills in STEM-based science online learning still need to be optimized. The study's findings suggest that ETE lecturers in Indonesia should broaden their knowledge and perspectives in STEM-based learning and communication management. Second, ETE lecturers in Indonesia must take the assessment of communication skills more seriously. Last but not least, the government, with the help of researchers, must devise an excellent assessment system to overcome time constraints. The results of this study revealed that STEM-based online science learning is being implemented.

Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review

Article

Full-text available

Dec 2021

Objective To characterise the extent to which health professionals perform SBAR (situation, background, assessment, recommendation) as intended (ie, with high fidelity) and the extent to which its use improves communication clarity or other quality measures. Data sources Medline, Healthstar, PsycINFO, Embase and CINAHL to October 2020 and handsearching selected journals. Study selection and outcome measures Eligible studies consisted of controlled trials and time series, including simple before-after design, assessing SBAR implementation fidelity or the effects of SBAR on communication clarity or other quality measures (eg, safety climate, patient outcomes). Data extraction and synthesis Two reviewers independently abstracted data according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses on study features, intervention details and study outcomes. We characterised the magnitude of improvement in outcomes as small (<20% relative increase), moderate (20%–40%) or large (>40%). Results Twenty-eight studies (3 randomised controlled trials, 6 controlled before-after studies, and 19 uncontrolled before-after studies) met inclusion criteria. Of the nine studies assessing fidelity of SBAR use, four occurred in classroom settings and three of these studies reported large improvements. The five studies assessing fidelity in clinical settings reported small to moderate effects. Among eight studies measuring communication clarity, only three reported large improvements and two of these occurred in classroom settings. Among the 17 studies reporting impacts on quality measures beyond communication, over half reported moderate to large improvements. These improvements tended to involve measures of teamwork and culture. Improvements in patient outcomes occurred only with intensive multifaceted interventions (eg, early warning scores and rapid response systems). Conclusions High fidelity uptake of SBAR and improvements in communication clarity occurred predominantly in classroom studies. Studies in clinical settings achieving impacts beyond communication typically involved broader, multifaceted interventions. Future efforts to improve communication using SBAR should first confirm high fidelity uptake in clinical settings rather than assuming this has occurred. PROSPERO registration number CRD42018111377.

Communication skills training through 'role play' in an acute critical care course

Article

Full-text available

Mar 2021
NATL MED J INDIA

Background: . Effective patient-doctor communication is a key component of patient-centred care, which is one of the six pillars of quality healthcare delivery. Structured and effective communication skills training for healthcare providers is the need of hour in medical education. We assessed the efficacy of role play and simulation in developing communication skills. Methods: . As a key component of an acute critical care course (ACCC), communication skills are taught using role play models and simulation. Live feedback is critical in learning during this course as per the principles of adult learning (andragogy). Quantitative and qualitative data were collected to assess the efficacy of ACCC. Results: . The 19th ACCC was introduced to interns at the All India Institute of Medical Sciences, New Delhi in December 2018. The teaching methodology and objective-oriented structured training in ACCC were much appreciated for training in human factors with emphasis on communication. A positive response was obtained from the candidates 3 weeks after they completed the course to assess whether interns are able to make use of this training in their day-to-day clinical practice amounting to a reliable evidence level of Kirkpatrick's 'return of investment'. Conclusion: . The use of 'role play' to teach communication skills is effective and superior to lecture-based teaching. Further structured and interactive programmes in communication skills training will improve patient care, relatives' satisfaction and the image of medical profession.

Dr Venki Ramakrishnan's lecture on the discovery of structure of ribosomes

Article

Mar 2021
NATL MED J INDIA

Comunicação no cuidado em saúde: Concepções e vivências de discentes e docentes de Enfermagem

Chapter

Full-text available

Jul 2021

Introduction The communication skill involves the exchange between verbal and non-verbal messages between individuals. In the field of nursing, it is a skill in the process of caring for users and a work tool among different professionals for care centered on the user / family, being relevant during the process of graduation training. Throughout the training process of the nursing student, different contexts and factors that may have an impact on professional practice must be considered. Goals: to analyze the conceptions of professors and students of the undergraduate nursing course about health communication. Methods: a described, exploratory study with a qualitative approach. It was developed from the techniques of narratives (with undergraduate nursing students) and semi-structured interviews with nursing professors, from guiding questions about the concept of communication, their experiences about communication during training and communication between nurses and users. The data were analyzed from the generation of descriptive and analytical codes, for categorization. Results Narrative data were collected from 131 students and 10 teacher interviews. The data were grouped into three categories: 1) Communication concepts, their forms of expression; 2) Communication in nursing care, its relationship and application in the nurse's work; 3) Applications of communication in the context of nursing undergraduate education. Conclusions: Nursing students and teachers recognize the importance of communication, but mention the lack of tools and practices that make users more participants in the decisions involved in care. Such aspects need to be addressed throughout the training process, through teacher mediation.

Teamwork Communication in Healthcare: An Instrument (Questionnaire) Validation Process

Chapter

Full-text available

May 2021

Healthcare face many problems, one of these problems is embodied in teamwork communication systems, the current HISs lack of teamwork communication tools. To introduce a teamwork communication instrument (questionnaire) in healthcare which plays a key role in health information system area. The proposed a research model for this study applied a quantitative approach using a survey method. To formulate the problem a preliminary data was collected by survey method to test and introduce a validated instrument (questionnaire). This study proposed and validated an instrument (questionnaire) to be used in healthcare teamwork communication studies. The findings of this study will be contributed to teamwork communication in healthcare and will be a reference for any healthcare communication related study. This study is the first of its kind in Jordan and has added a new dimension in the teamwork communication in healthcare.

Exploring a Nursing Home-Specific, Interdisciplinary, Function-Focused, Communicative Framework Based on Situation, Background, Assessment, and Recommendation

Article

Full-text available

Mar 2021
J Nurs Res

Background: Improved methods of communication are needed among professionals in related fields to address the increasing complexity of clinical situations and various levels of functioning experienced by older adults who live in nursing homes. Purpose: The purpose of this study was to explore function-focused clinical communication among nurses and providers based on the Situation, Background, Assessment, Recommendation (SBAR) approach toward interdisciplinary collaboration to maintain function among nursing home residents and to identify the characteristics of SBAR flows in nursing homes. Methods: Detailed interviews with 28 interdisciplinary professionals working in four nursing homes were conducted. Directed qualitative content analysis was used to identify the internal attributes of SBAR-based communication. Case analysis was conducted to identify SBAR flows. Results: Four themes emerged as key factors for function-focused interdisciplinary staff communication in nursing homes. Effective nursing care to maintain function among nursing home residents requires accurate awareness of abnormal circumstances. Knowledge of assessment and resident background are needed to address situations requiring intervention and identify the problems underlying a resident's current state. The optimal therapeutic environment is created by sharing roles and tasks among practitioners through referrals.Twelve generalized situations requiring function-focused communication (i.e., dislocation of body line because of joint contracture, change in walking, difficulty of moving because of pain, difficulty in eating, fever, change in sleep pattern, change in excretion pattern, change in weight, change in condition, change in problematic behavior, decrease in cognitive function, and change in relationships) and the related nurse-centered SBAR pathways were identified. Conclusions/implications for practice: These results represent a first prototype for developing practical communication guidelines for nursing-home-specific function-focused care and provide new insights into the interdisciplinary approach.

Nursing handover in the Indonesian hospital context: Structure, process, and barriers

Article

Full-text available

Mar 2021

Background: Nursing handover is an essential part of nursing practice to safe patient care, which occurs among nurses between shifts for transferring professional responsibility and accountability. However, there is limited information about the implementation and evaluation of nursing handover in Indonesian hospitals. Objective: This study aimed to describe the structures, processes, and barriers of the nursing handover in the Indonesian hospital context. Methods: This study employed a case study design in five inpatient units, especially in the medical-surgical wards of a referral hospital in Indonesia. The study was conducted from August to November 2018. A total of 100 handovers and 76 nurses were included. Focus group discussions were conducted in head nurses, nurse team leaders, and registered nurses. Observations were implemented to capture the handover process, including the number of the nurses in and out and the content of the information covered situation, background, assessment, and recommendations (SBAR). Data were analyzed using content analysis and fishbone analysis. Results: The nursing handover consisted of three phases: before, during, and after. The handover barriers were divided into manpower, material, money, method, environment, and machine. The content of handover varied according to nurses’ familiarity with the patients and their complexity. The nurses also actively participated during the handover process, although some nurses were absent in the handover time. About 75% of nurses had sufficient knowledge about the shift handover process using SBAR. The SBAR was adopted as a standard for handover, but no specific guideline or standard operating procedure. Conclusion: The results of this study can be used as basic information to develop a guideline of nursing handover and supervision in the context of hospitals in Indonesia and beyond. Funding: This study was funded by the Department of Nursing, Universitas Indonesia, Indonesia.

Debriefing and Learning Strategies: A Comparison between Two Reflective Analysis Styles with/without a Graphical Record of Strengths/Weaknesses

Article

Full-text available

Jan 2021

Background: Clinical simulation efficiently complements the training of Nursing Degree students. The debriefing phase is the most important feature of simulation-based learning, where the students are able to acquire the necessary competences. It is at this stage where learning strategies and motivation play a crucial role. The objective of the study was to analyze the relationship between the style of debriefing utilized in the simulation sessions, and the learning strategies of Nursing Degree students who participated in a high-fidelity clinical simulation. Method: This was a quasi-experimental study conducted with a sample of 200 students in their third and fourth years at university. To obtain the data, an evaluation Questionnaire for the Evaluation of Learning Strategies of University Students (CEVEAPEU) was utilized, as well as two different types of structured debriefing styles, namely, with or without a graphical representation of the strengths/weaknesses during the analytical phase. The data analysis was performed with the SPSS ® v25 program. Results: Statistically significant differences were found, with higher scores obtained when utilizing debrief-ing with a graphical representation, on both scales of the questionnaire (affective and cognitive), on the motivational, metacognitive and processing, and use of information subscales, and twelve learning strategies mostly belonging to the subscales of motivation; searching, collecting, and selecting information; and processing and using information. Conclusion: Debriefing with a graphical representation is deemed, a priori, as the most adequate approach for our context, based on the greater number of learning strategies utilized by our students. The use of a written graphical record of the strengths and weaknesses in the analytical phase is recommended.

The impact of simulation-based triage education on nursing students' self-reported clinical reasoning ability: A quasi-experimental study

Article

Jan 2021
Nurse Educ Pract

Few studies have comprehensively examined the effectiveness of simulation-based triage education on clinical reasoning of nursing students. This study evaluated the impact of a simulation-based triage exercise on nursing students’ self-reported clinical reasoning ability. Three cohorts of third-year nursing students were divided into intervention group a (IG a, n = 62), intervention group b (IG b, n = 57), and a control group (CG, n = 53). Students in IG a and IG b participated in a simulation-based triage education consisting of 2 h of multiple patient triage simulations and an hour of structured debriefing. The CG participated in a traditional didactic triage course consisting of a 3-h lecture. Self-reported clinical reasoning ability in pre and post-triage education was measured by the Nurses Clinical Reasoning Scale. There was no significant difference in mean clinical reasoning ability scores between the three groups in pre-test (p > 0.05). Clinical reasoning ability scores in post-test among students in IG a and IG b were significantly higher than those in CG (p < 0.001). Nursing students exposed to a simulation-based triage education had more improvement in self-reported clinical reasoning ability as compared with students who participated in a lecture-based triage education program.

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

Article

Full-text available

Nov 2020

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.

Development and Evaluation of a Simulated Conflict Management Program on Inter-Professional Communication Skills

Article

Sep 2020

Yeonjae Jo

Capturing Debriefing and Enhancing Reflection within Simulated Clinical Learning Environments

Article

Full-text available

Jun 2020

This article presents findings from an evaluation of a new A3-size learner notes sheet designed for use by healthcare students engaging in clinical simulation and clinical skills sessions. The notes sheet consists of an adapted form of the SBAR (situation, background, assessment, response) tool, whilst capturing post-simulation oral debriefing provided by a facilitator. Additionally, the Driscoll (2007)model is used to provide students with an opportunity to reflect on their engagement in clinical simulation. Two cohorts of students, who engaged in separate simulation sessions, completed the A3 sheet. The study featured 33 midwifery and 21 operating department practitioner (ODP) students undertaking a simulation. Documentary analysis was undertaken to identify the depth of reflective writing of both groups of students. Midwifery student participants reflected on their experiences of simulation at a slightly deeper level than their ODP counterparts. All students adhered to the structure of the notes sheet when receiving their briefing from the facilitator and when asked to write their reflective accounts. This study has sought to explore an under-researched area of clinical simulation: the extent to which healthcare students can utilise reflection when engaging with a clinical scenario within a simulated learning environment.

Il passaggio di consegne tra Emergenza Territoriale e Pronto Soccorso: studio osservazionale con metodo SBAR

Article

Jan 2018

Introduzione: il passaggio delle consegne tra il personale del servizio di emergenza 118 e il personale di Pronto Soccorso ha importanti implicazioni per la cura del paziente. Ãˆ essenziale quindi che la trasmissione delle informazioni avvenga in maniera completa e corretta, rapida ed efficace.

VeritÃ Ã¨ rassicurazione: il progetto www.intensiva.it

Article

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Jan 2018

Il progetto intensiva.it Ã¨ dedicato ai familiari dei pazienti critici. Nasce dalla collaborazione di diverse figure professionali (infermieri, medici, psicologi, linguisti) di 14 ospedali italiani, che si sono interrogati su come migliorare gli aspetti comunicativo-relazionali in un contesto difficile come quello della terapia intensiva, con lâ€™obiettivo di coniugare veritÃ e rassicurazione, ritenendo che una maggiore comprensione di quello che accade in questo reparto permetta ai congiunti di sentirsi meno soli e impotenti, ma consolati e compresi.

“My gut feeling is…”: An Ethnographic Study Exploring Interprofessional Communication About Children and Adolescents With Chronic Musculoskeletal Pain in Paediatric Rheumatology

Article

Jul 2023

Interprofessional communication about inflammatory and non-inflammatory musculoskeletal conditions is an important component of assessment and management in paediatric rheumatology. Chronic pain is a feature of some of these conditions which likely influences the extent and type of communication about pain. Research investigating interprofessional communication about paediatric pain is limited but has found that communication is inclusive of the biopsychosocial context of children/adolescents as well as their families. The aim of this ethnographic study was to explore interprofessional communication about children and adolescents with chronic musculoskeletal pain in paediatric rheumatology. We observed forty-five healthcare professionals recruited from three UK paediatric rheumatology teams during thirty multi-disciplinary team meetings. Contemporaneous field notes created during observations were analysed using grounded theory procedures. Core processes identified in interprofessional communication involved describing, making sense of, and managing children/adolescents with pain and their families. Topic areas discussed within these core processes included healthcare professional perceptions about children's and parents' personality characteristics, as well as healthcare professionals' familiarity with families. Underlying diagnoses and possible attributions of pain aetiology were also discussed. Interprofessional narratives included consideration of the potential anxieties and uncertainties about pain within families. Healthcare professionals communicated about strategies for managing expectations about pain. These findings characterise the nuances in interprofessional communication about pain and can be used to inform future work aimed at understanding and optimising the impact of interprofessional communication on clinical decisions and pain outcomes. PERSPECTIVE: This study characterises the processes [series of actions], the function [purpose] and the content [topic areas] of interprofessional communication about paediatric pain in rheumatology settings. These findings should be used to inform interventions targeting both the appropriateness and effectiveness of this communication.

The Correlation Between Communication Skills With Self-efficacy and Clinical Competence of Operating Room Students of Qom Paramedical School

Article

Full-text available

Jan 2023

Background and Objectives: This study aims to investigate the relationship of communication skills with clinical self-efficacy and clinical competence in operating room students. Methods: This is a descriptive-correlational study. Participants were 100 operating room students from the School of Allied Medical Sciences, Qom University of Medical Sciences, Qom, Iran in 2021, who were selected by a census method. To collect data, in addition to a demographic form (surveying age, sex, semester), Queendom communication skills test, perceived perioperative competence scale-revised, and clinical self-efficacy questionnaire were used. Descriptive statistics (Percentage, Mean±SD) and inferential statistics (Pearson correlation test, independent t-test, and ANOVA) were used in analyzing the data. Results: There was a significant and positive correlation between communication skills and clinical competence (r=0.478, P≤0.001) and between communication skills and clinical self-efficacy (r=0.445, P≤0.001). Conclusion: Communication skills of Iranian operating room students have a positive and significant relationship with their clinical self-efficacy and clinical competence. Considering the importance of communication skills in providing safe and high-quality patient care, attention should be given to the communication skills training of these students by the educational planners and managers.

Early recognition and management of the seriously ill child

Chapter

Mar 2023

Detailing experienced nurse decision making during acute patient care simulations

Article

Feb 2023

Introduction: Nurse decision making (DM) is critical for patient safety. Eye-tracking methods can effectively assess nurse DM. The purpose of this pilot study was to use eye-tracking methods to assess nurse DM during a clinical simulation. Materials and methods: Experienced nurses managed a simulated patient manikin who suffered from a stroke mid-simulation. We assessed nurses' gaze patterns prior to and after the stroke. DM in general was assessed by nursing faculty using a clinical judgement rubric, and dichotomously based on recognition of the stroke or not. Results: Data from eight experienced nurses was examined. For the nurses who recognized the stroke, visual attention was focused on the vital sign monitor and patient's head, which suggest those locations were consistently examined for correct decision-makers. Conclusions: Dwell time on general AOIs was associated with poorer DM, which may reflect poorer pattern recognition. Eye-tracking metrics may be effective to objectively assess nurse DM.

Recovery/PACU

Chapter

Feb 2023

De meeste patiënten die anesthesie hebben gehad, gaan daarna naar de recovery (verkoeverkamer) ofwel PACU. In dit hoofdstuk wordt postoperatieve monitoring besproken. Tevens wordt er dieper ingegaan op pijn, pijnbeleving en de mogelijkheden voor pijnstilling. Veel ziekenhuizen zetten daarvoor een Acute Pijn Service (APS) in. Communicatietechnieken spelen een belangrijke rol in de medische wereld, zoals bij overdrachten en in situaties waarbij de toestand van de patiënt zorgwekkend is (bijvoorbeeld postoperatief). Een gestructureerde methode die veel wordt gebruikt, is de zogeheten SBAR met de readbackprocedure.

Gender Bias and Performativity

Chapter

Jan 2023

This chapter addresses gender bias, gender performativity, and sexual harassment in the clinical setting. The prevalence of gender disparities and bias is well documented in fields such as orthopedic surgery, urology, radiology, neurosurgery, and plastic surgery. Marginalized groups are more frequently impacted by these negative behaviors. Notably, in the field of urology, female residents comprise less than 30% of the demographic and often face bias. Gender performativity may play a role in the stereotyping seen for males in the nursing profession. Traditional views of masculinity and femininity may limit a supervisor's ability to see the potential in clinical staff members and cause conscious or unconscious limitations for professional growth. The interactions represented in these cases offer an opportunity for discussion of the prevalence and impact of gender bias and associated microaggressions in medicine. Various strategies to effectively mitigate gender bias in the clinical and academic environment are also discussed.

Interprofessional teamwork in healthcare: Observations and the road ahead

Article

Aug 2022

In this effort we draw from the literature on interprofessional teamwork in high reliability organizations from different fields of study, including healthcare, industrial/organizational psychology, and management. We combine this literature with our collective experience to offer five observations on future needs for the field of team science research and practice. These themes include: (1) exploration of nonclinical teams, (2) evaluation of multi-team systems in healthcare, (3) the study of dyad leadership of teams, (4) the proliferation of virtual healthcare teams, and (5) the continuing integration of organizational and team science into the study of interprofessional teams. By presenting these observations, we argue why each is critical to the overall understanding of interprofessional teamwork in healthcare and provide areas for future scholarly advancement that will inform healthcare practice.

The patient safety in extracorporeal blood purification treatments of critical patients

Article

Full-text available

Jul 2022

Today, health systems are complex due to both the technological development in diagnostic and therapeutic procedures and the complexity of the patients that are increasingly older with several comorbidities. In any care setting, latent, organizational, and systematic errors can occur causing critical incident harmful for patients. Management of patients with acute kidney injury (AKI) requires a multidisciplinary approach for the diagnostic-therapeutic-rehabilitative path that can also require an extracorporeal blood purification treatment (EBPT). The complexity of these patients and EBPT require a clinical risk analysis and the introduction of protocols, procedures, operating instructions, and checklists to reduce clinical risk through promotion of the safety culture for all care providers. Caregivers must acquire a series of tools to evaluate the clinical risk in their reality to prevent incidents and customize patient safety in a proactive and reactive way. Established procedures that are made more needed by the COVID-19 pandemic can help to better manage patients in critical care area with intrinsic higher clinical risk. This review analyzes the communication and organizational aspects that need to be taken into consideration in the management of EBPT in a critical care setting by providing tools that can be used to reduce the clinical risk. This review is mostly addressed to all the caregivers involved in the EBPT in Critical Care Nephrology and in the Intensive Care Units.

Telephone-Based Structured Communication Simulation Program for the Follow-Up of COVID-19 Cases and Contacts in Primary Care

Article

Full-text available

Mar 2022
Int J Environ Res Publ Health

(1) The COVID-19 pandemic has had many consequences on health systems worldwide. In the Spanish health system, telephone-based consultations were coupled to in-person consultations. This type of consultation was mainly a challenge for the primary care teams, who had to assume the greatest load of care provision. The objective of the present study was to discover the satisfaction and perception of health professionals related to a training program on efficient communication based on high-fidelity simulation. (2) Methods: A cross-sectional descriptive study based on a convergent and parallel mixed method. The satisfaction and perception of 275 health professionals associated with COVID-19 training based on the structured communication model CERCAR© was analyzed. (3) Results: The assessment of the satisfaction with the training and methodology was high. With respect to the transfer of information, the participants gave a high score to the categories of consolidation of learning, applicability to their work, and benefits for the institution. The qualitative results supported these findings. (4) Conclusions: The training program and its virtual modality were well received, and had a high degree of transference. The application of active, online learning methodologies is a relevant format for continuous education.

The effect of ISBARR on knowledge of and attitudes about interprofessional communication skills among Chinese undergraduate nursing students

Article

Nov 2021
NURS EDUC TODAY

Background Interprofessional communication is essential for the coordination and collaboration of healthcare team members during patient care, especially in critical situations. Therefore, nursing students must learn and practice interprofessional communication skills throughout their education and clinical training. Previous studies evaluating standardized communication frameworks in the United States (e.g., ISBARR [identify, situation, background, assessment, recommendation, and repeat]) suggest that nursing students feel more confident about interprofessional communication and collaboration through familiarity with these frameworks. Objective To evaluate the effect of an ISBARR workshop on knowledge of and attitude about effective communication among Chinese undergraduate students. Design A pre- and posttest quasi-experimental study. Participants A convenience sample of 90 undergraduate nursing students at a vocational health college in China. Method The two-part ISBARR workshop featured a lecture and a video-simulation exercise. Differences in students' knowledge of and attitudes about interprofessional communication skills using ISBARR were compared pre- and post-workshop. Results We observed a statistically significant (p < 0.001) improvement in overall mean scores of students' knowledge of and attitudes about utilizing ISBARR post-workshop. We also observed a statistically significant (p < 0.001) improvement in the overall mean scores of students' knowledge of and attitudes about ISBARR after the video-simulation exercise. Conclusion The ISBARR workshop improved Chinese nursing students' knowledge and attitudes about interprofessional communication. Incorporating ISBARR into the nursing healthcare team eventually can lead to improved patient safety. Subsequent studies should target nursing faculty and clinical instructors to evaluate their knowledge and attitudes about teaching ISBARR and interprofessional education. Improving these attitudes can help establish a positive interprofessional communication learning environment for nursing students in China and other cultural contexts worldwide.

Communicative Competencies in Nursing: A Situation- and Competence-Based Curriculum

Chapter

Sep 2021

The project (model) curriculum communicative competences in nursing aimed at developing a curriculum for promoting communicative and counseling skills in the training of nurses to improve standardization of teaching and learning for communication competencies in nursing schools in Germany. The project focused on determining outcomes, content, methods of teaching and learning, and the order of the learning situations for the 3 years of training. In this publication, we will describe our approach for developing the curriculum and the curriculum principles we have used. The curriculum is competence-based, partial competencies of communicative competence are gradually fostered to an increasingly higher level. It is also situation-based, with learning situations becoming more and more complex as the training progresses. Also, various epistemological approaches were integrated into the learning situations.

Linear Sequential Unmasking–Expanded (LSU-E): A general approach for improving decision making as well as minimizing noise and bias

Article

Full-text available

Aug 2021

All decision making, and particularly expert decision making, requires the examination, evaluation, and integration of information. Research has demonstrated that the order in which information is presented plays a critical role in decision making processes and outcomes. Different decisions can be reached when the same information is presented in a different order. Because information must always be considered in some order, optimizing this sequence is important for optimizing decisions. Since adopting one sequence or another is inevitable —some sequence must be used— and since the sequence has important cognitive implications, it follows that considering how to best sequence information is paramount. In the forensic sciences, existing approaches to optimize the order of information processing (sequential unmasking and Linear Sequential Unmasking are limited in terms of their narrow applicability to only certain types of decisions, and they focus only on minimizing bias rather than optimizing forensic decision making in general. Here, we introduce Linear Sequential Unmasking–Expanded (LSU-E), an approach that is applicable to all forensic decisions rather than being limited to a particular type of decision, and it also reduces noise and improves forensic decision making in general rather than solely by minimizing bias.

Effectiveness of assertiveness training, SBAR, and combined SBAR and assertiveness training for nursing students undergoing clinical training: A quasi-experimental study

Article

May 2021
NURS EDUC TODAY

Background Nursing students experience notable challenges when communicating with patients, caregivers, and health-care providers during clinical training; this adds to the stress they experience from clinical training and deteriorates their clinical competence. Objectives The aims of this study are to develop and assess a practical program for improving communication skills, clinical practice stress, and clinical competence among nursing students undergoing clinical training. This is performed by administering and evaluating the respective effects of an assertiveness-training program; a program based on the situation, background, assessment, and recommendation (SBAR) technique and a program that combines assertiveness training with the SBAR technique. Design This study used a non-equivalent, quasi-experimental pretest-posttest design. Settings This study was conducted at the nursing schools of two universities in the north and west of South Korea. Participants Ninety-three third-year nursing students were recruited through convenience sampling from two universities in South Korea. Methods The participants were randomly allocated to a group that received assertiveness training only, a group that received the SBAR technique only, or a group that received a combination of assertiveness training and the SBAR technique. Each program featured four sessions of 60–70 min each. Communication competence, communication clarity, assertive behavior, clinical training stress, and clinical competence were measured. Results The group that received the combination of assertiveness training and the SBAR technique showed a significant improvement in communication clarity, a significant reduction in clinical training stress compared to both of the other groups, and improved clinical competence when compared to the group that received the SBAR technique only. Conclusions A program that combines the SBAR technique with assertiveness training can be utilized to improve communication skills, reduce clinical training stress, and enhance clinical competence in nursing students.

Situation, Background, Assessment, and Recommendation Stepwise Education Program: A quasi-experimental study

Article

Mar 2021
NURS EDUC TODAY

Jisun Lee

Background A nurse, as the main subject of decision-making in clinical settings, experiences various situations that require communication with a range of health care providers. The communication process is important to the process of recognizing problems and choosing one among the available alternatives after reflection, which requires communication skills based on critical thinking. Communication competence is one of the basic competencies of nurses, and it is also important for providing qualitative healthcare service. Objective To investigate how Situation, Background, Assessment, and Recommendation Stepwise Education Program (SBAR SEP) developed on the basis of the revised Bloom's Taxonomy affects nursing students on their communication competence and critical thinking. Design Non-equivalent control group pretest–posttest design. Settings A university in South Korea. Participants A total of 96 nursing college students (48 in the experimental group and 48 in the control group). Method The subjects were allocated using convenience sampling to one of the two groups: SBAR SEP or control. Subjects in SBAR SEP group received a lecture-style training of SBAR a week prior to clinical practicum and performed role-play during the two-week clinical practicum. The duration of the SBAR SEP role-play intervention was 2 weeks, twice a week, for 120 min each session. A control group performed a regular case presentation in the clinical practicum. Data were collected from August to October 2019. Data were analyzed using descriptive statistics, χ² test, independent t-test, and ANCOVA using SPSS 25.0. Results A significant increase was observed in the scores of communication competence (p < .001) and critical thinking (p < .001) in the experimental group compared with the control group. Conclusions The SBAR SEP for nursing students is an effective educational method that improves communication competence and critical thinking under similar circumstances at the clinical site.

Barriers and facilitators of implementing an antimicrobial stewardship intervention for urinary tract infection in a long-term care facility

Article

Full-text available

Feb 2021

Background Fifty percent of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm. Most studies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)–focused antimicrobial stewardship (AS) intervention at a LTCF, with the secondary objective of exploring the pharmacist’s potential roles. Methods The study used a qualitative descriptive design. Participants attended either a focus group or one-on-one interview. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barrier and facilitator themes were mapped using the capability, opportunity, motivation and behaviour (COM-B) model. Similarly, themes were identified from the transcripts regarding the pharmacist’s roles. Results Sixteen participants were interviewed. Most barriers and facilitators mapped to the opportunities domain of the COM-B model. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors, while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. Conclusion This study supports the importance of tailoring interventions to target factors underlying barriers to behaviour change. At this LTCF, an effective antimicrobial stewardship intervention should incorporate strategies to improve access, knowledge, communication and collaboration in its design, having sufficient resources and addressing external factors to optimize its success and long-term sustainability. Can Pharm J (Ott) 2021;154:xx-xx.

The Effect of Peer Support Approach on Communication Skills of Nursing Students in Pediatric Clinical Setting.

Article

Feb 2021
Nurse Educ Pract

Peer support is a valuable teaching-learning approach to enhance deep learning in the clinical environment. The purpose of the present study was to investigate the effect of peer support on the communication skills of undergraduate nursing students when interacting with hospitalized children and their parents. This was a pre-and post-test quasi-experimental study with two groups. Through the cluster random sampling method, six practical groups of students who undertook a 3-week pediatric practicum were selected. Three groups were allocated to the experimental (n=51) and control groups (n=52). Two volunteer post-graduate students in pediatric nursing formed the peer group. First, the peers participated in three 45-min sessions using different scenarios about communication skills. They then tutored the intervention group to improve their communication skills. The communication skills with 5 children and 5 parents were observed for each undergraduate student via the checklist. The experimental group demonstrated significantly higher mean scores of the communication skills than the control groups in post-test (P<0.001). Moreover, the mean scores of communication skills was significantly higher in post-test than pre-test in both the experimental and control groups (p<0.001). Peer support approach promoted the communication skills of undergraduate nursing students in pediatric clinical setting.

Evaluating the Impact of ACLS Scenario Based Resuscitation Simulation for Emergency Team

Article

Full-text available

Feb 2021

Introduction: Medical simulation has become increasingly important for education in emergency situations like resuscitation and improvising healthcare services. Methods: A prospective study was performed implementing ACLS resuscitation simulation with the Patan Hospital emergency team. The survey questionnaire was designed to evaluate participants’ communication skills, leadership, team dynamics, competency in ACLS and perception regarding simulation as a learning method. The paired t-tests were performed to compare pre and post simulation survey responses. The quantitative data were managed and analysed using Microsoft Excel. Results: Fifty seven emergency staffs participated in the study. In the communication domain pre-simulation survey mean likert score of close loop communication was 2.68, SBAR was 2.54 and PEARL was 2.25 while the post-simulation survey were 3.19, 3.05 and 2.96 respectively. In leadership pre-survey assessment of coordinating team members was 2.61 and summarising events skill was 2.58 while the post-survey scores were 2.91 and 3.02 respectively. The team dynamics pre-survey of the teamwork experience was 2.63 while post-survey was 3.07. The competency pre-survey of competency level in ACLS was 2.51 while the post-survey was 2.88. The pre-survey regarding considering simulation a good method of training was 3.32 while the post-survey was 3.56. All the survey questionnaires of each domain showed the increased difference that is statically significant with p-values <0.001. Conclusions: Simulation training is an effective and useful educational technique for training the health personnel working in emergency service.

Effectiveness of a training intervention to improve communication between/awareness of team roles: A randomized clinical trial

Article

Mar 2021
J PROF NURS

Background Interprofessional teamwork training of nursing undergraduates is essential to improving healthcare. The absence of clear role definitions and poor interprofessional communications have been listed as the main reasons behind abandonment of the profession by recently graduated nurses. Purpose The aim of this parallel randomized clinical trial was to evaluate the impact of Situation-Background-Assessment-Recommendation (SBAR) role-play training on interprofessional teamwork skills (role-related and communication-related) and non-technical skills (patient assessment, patient intervention, patient safety, and critical thinking). Method The intervention group were taught teamwork skills, role and task assignment skills, and use of the SBAR worksheet in a 1-hour role-play training session, while the control group received conventional lecture-based training. Teamwork and non-technical skills were then assessed in high-fidelity simulation scenarios using the KidSIM Team Performance Scale (teamwork skills) and the Clinical Simulation Evaluation Tool (non-technical skills). Cohen’s d (d) was used to examine effect size differences. Results Compared to the control group, the intervention group improved in 4 teamwork items – ‘verbalize out loud’(p<0.001, d=0.99), ‘paraphrase’ (p<0.001, d=0.77), ‘cross-monitoring’ (p<0.001, d=0.72), and ‘role clarity’ (p=0.002, d=0.66) – and in a single non-technical skill (patient intervention: p=0.004, d=0.66), while also reporting greater confidence in performing patient assessments (p=0.02, d=0.56). Conclusions Role-play and SBAR training for undergraduate nurses improved patient intervention, enhanced information sharing in an interprofessional team, and raised awareness of their own and other team members’ roles.

DEVELOPMENTAL PERCEPTIVENESS ON STRATEGIES FOLLOWED IN ICU FOR THE TREATMENT OF INTERDISCIPLINARY COMMUNICATION

Article

Full-text available

Dec 2017

Stefanos Digonis

Abstract Introduction: Patients require quality health care, otherwise in Intensive Care Units (ICU). A key component to this service successfully is effective communication between multidisciplinary team. Τhe aim of the present study was to review the adoption of standard protocol - a tool for ensuring the quality of care given the difficulties that developed in the communication between the multidisciplinary team and in particular between the hospital and the medical sector. Material & Method: The search method used in electronic databases (Medline, Pubmed, Embase). The keywords used were "SBAR protocol", "Communication", "ICU", and combinations thereof. Specifically, they read the abstracts and rejected many were not relevant to the topic. From systematic literature review identified 34 studies, of which 18 were used which concerned the application of this standard in intensive care units. Results: It is necessary to introduce changes in each ICU. Daily use of the tool SBAR (Situation, Background, Assessment, and Recommendation) facility showed signs of individual process. The structure, cohesion and intimacy provided by the SBAR tool, resulted in improved situational awareness proportioned and long process, staff, and patient benefits. Conclusions: The implementation of a new process finds ally facilitate effective communication so as not created undermining the credibility of nursing science, with the adoption of specific communication tools. Keywords: Communication, ICU, nursing stuff, SBAR protocol, SWOT analysis

Systematic Rounding Tool for Nurse Practitioner Students

Article

Aug 2020

Assessing student confidence in interprofessional communication during primary care advanced pharmacy practice experiences (APPEs)

Article

Jul 2020

Background and purpose Students must have experience communicating and interacting with healthcare professionals throughout pharmacy school curricula to effectively develop interprofessional communication abilities and confidence. This study’s purpose was to assess student confidence in interprofessional communication utilizing a rubric and checklist inspired by the situation-background-assessment-recommendation (SBAR) technique throughout five-week primary care advanced pharmacy practice experiences (APPEs). Educational activity and setting A six-item rubric was created for student self-evaluation of interprofessional communication throughout their APPE. Students completed the rubric twice to evaluate change in confidence. Additionally, a pre-post rotation survey was developed to assess students’ comfort level rounding with healthcare professionals and interacting/intervening with other healthcare professionals to address a medication-related problem. A paired t-test was used to evaluate changes in perceived student confidence in rubric self-evaluations and pre- and post-APPE surveys. Findings From May 2017 to April 2019, 93 students completed primary care APPEs with faculty authors, and 181 encounters were self-evaluated using the rubric. Forty-eight students completed all rubric sections twice; their mean self-evaluation score increased significantly from 15.25/18 to 17.10/18 (P < .001). Self-evaluation scores increased significantly on all rubric sections (P < .05) except professional language (P = .133). Student comfort level rounding with healthcare professionals and interacting/intervening with healthcare professionals to address a medication-related problem increased significantly (P < .001). Summary Interprofessional communication practice, preceptor observations and feedback, and utilization of an interprofessional SBAR-inspired communication rubric contributed to improved student confidence in making patient care recommendations to physicians.

Effect of SBAR Training Program on Baccalaureate Nursing Students Self-Confidence in Shift Reporting

Article

Full-text available

Jan 2020

Abstract: Patients can receive complete care through accurate and concise transfer of patient's clinical information from one nurse to another during different shifts. Effective communication plays an important role in providing safe patient care and decreasing medical mistakes. The aim of this study was to assess the effect of SBAR communication training program on baccalaureate nursing students' self- confidence in shift reporting. This study was conducted at Nursing Faculty, Zagazig University, Egypt. For this research, a quasi-experimental design was used with a simple random sample of 81 students from the above mentioned setting. Data was collected using two tools; SBAR Knowledge Acquisition Quiz (SBRAKAQ) and Self-Reported Anxiety and Confidence Scales (SRACS). Results showed that there was highly statistically improvement in nursing students' SBAR communication mean score, self-reported confidence and self-reported level of preparedness during shift reporting after training program implementation where P- value < 0.01. Moreover, the mean score of nursing students' self- reported anxiety during shift reporting decreased after training program implementation (p-value< 0.01). Conclusion: SBAR communication was significantly correlated with improving nursing students' self-confidence in shift reporting. Recommendation: healthcare facilities and educational institutions should adopt the use of the SBAR and provide continuous instructions for the SBAR tool throughout the curriculum includes specific applications at each student's level. Keywords: SBAR communication, Confidence in Shift reporting, Nursing students

Developing Interprofessional Clinical Rotations in Low Income Areas: Learned Strategies for Healthcare Educators

Article

Jun 2020

April L. Stidham

This chapter describes the setting for interprofessional education and practice with an emphasis on the development of interprofessional clinical rotations. The barriers and challenges for healthcare facilities serving patients in rural areas with limited resources is outlined. The process for establishing academic and healthcare institutional partnerships is also discussed, along with strategies to prepare faculty to serve as preceptors.

Disruptive Behavior & Clinical Outcomes: Perceptions of Nurses & Physicians: Nurses, physicians, and administrators say that clinicians' disruptive behavior has negative effects on clinical outcomes

Article

Full-text available

Jan 2005

Providing safe, error-free care is the number-one priority of all health care professionals. Excellent outcomes have been associated with procedural efficiency, the implementation of evidence-based standards, and the use of tools designed to reduce the likelihood of medical error (such as computerized medication orders and bar-coded patient identification). But the impact of work relationships on clinical outcomes isn’t as well documented. Surveys were distributed to 50 VHA hospitals across the country, and results from more than 1,500 survey participants were evaluated. Nurses were reported to have behaved disruptively almost as frequently as physicians. Most respondents perceived disruptive behavior as having negative or worsening effects, in both nurses and physicians, on stress, frustration, concentration, communication, collaboration, information transfer, and workplace relationships. Even more disturbing was the respondents’ perceptions of negative or worsening effects of disruptive behavior on adverse events, medical errors, patient safety, patient mortality, the quality of care, and patient satisfaction. These findings suggest that the consequences of disruptive behavior go far beyond nurses’ job satisfaction and morale, affecting communication and collaboration among clinicians, which may well, in turn, have a negative impact on clinical outcomes. Strategies aimed at reducing the incidence and impact of disruptive behavior are recommended.

The human factor: The critical importance of effective teamwork and communication in providing safe care

Article

Full-text available

Nov 2004

Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

Environmental Noise Sources and Interventions to Minimize Them

Article

Full-text available

Jul 2008
J NURS CARE QUAL

Noise has been shown to interfere with the healing process and can disrupt the patient's experience. This study assessed patients' and staff's perceptions of noise levels and sources in the hospital environment and identified interventions to reduce the noise level. The interventions significantly reduced noise as perceived by patients and staff. Identification of a structured process to identify noise sources and standardization of noise measurement methods can improve the patient hospital experience.

Using the SBAR communication technique to improve nurse-physician phone communication

Article

Jan 2007

K.L. Rodgers

Shift Report and SBAR: Strategies for Clinical Postconference

Article

Sep 2008
NURS EDUC

Fatima Ascano-Martin

Differences in Perioperative Medication Errors With Regard to Organization Characteristics

Article

Mar 2006

RESEARCHERS CONDUCTED a descriptive, comparative, secondary analysis using a national database to investigate differences in perioperative medication error characteristics with regard to organization characteristics. PERIOPERATIVE MEDICATION ERROR records reported to the MEDMARX database between Sept 1, 1998, and Aug 31, 2003, were examined (N = 5,210), and variables were analyzed using descriptive and inferential statistics. Statistically significant differences were found for three out of four research questions. THE STUDY'S FINDINGS provide a foundation for perioperative medication error analysis and serve as a starting point for organizations to begin investigating the medication error problem in their facilities.

Improving clinical communication through structured conversation

Article

Sep 2006
NURS ECON

Mary Lou Manning

Communication failure plays an important role in causing medical errors. Clinical communication is highly complex and prone to error especially during transitions of patient care and emergent situations. Standardized approaches and tools may provide potential solutions to improve the quality of communication and prevent subsequent patient harm. The National Patient Safety Foundation, through its Stand Up for Patient Safety Program, is committed to assisting organizations improve clinical communication.

SBAR-it's not just another communication tool

Article

Jul 2007
Prof Case Manag

Suzanne K Powell

Raising the SBAR: How better communication improves patient outcomes

Article

Apr 2008
Nursing

Bridging the professional chasm: tools for collaborative communication.

Jan 2008
8

Anderson

The SBAR Communication Technique Teaching Nursing Students Professional Communication Skills

Abstract

No full-text available

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