Effective Communication Using The Sbar Model

New study finds U.S. hospitals must improve workplace communication to reduce medical errors, enhance quality of care. (2005, Jan 26).U.S.Newswire. Retrieved 3/8/12 from, http://search.proquest.com/docview/450869420?accountid=458

The health care institution has been considering a wide array of solutions to improving the quality of patient care within the facility, and it is now believed that a suitable course of action is represented by the improvement of the nurse reporting at the bed of the patient, at the change of the shifts. This strategy is beginning to draw more attention within the medical community, but it has yet to be fully adopted by the health care institutions.

Effective communication is crucial aspect of nursing yet too often is placed low on the priority list, especially at shift change. Information related to the care of patients is frequently disseminated at a crowded, noisy nurse station with several nurses rushing to leave and others attempting to get the information necessary to plan care and limit the constant distractions. It is this interaction that allows for information vital patient safety information to be communicated including the acuity of patients.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Cinahl Information Systems (2012) state communication patterns between patient care providers can fluctuate depending upon gender, cultural background, education level, stress, environmental disruptions, and individual communication styles. Using a standardized communication tool such as the SBAR technique, eliminates communication failure due to the diversity of communication patterns of patient care providers. SBAR allows communication to become precise, consistent, and simplistic.

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

Bedside shift reporting, is it necessary? Baker (2010) states that is has its benefits, from patient safety, increased patient involvement and staff teamwork, ownership and accountability.” (Baker, 2010) To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospital Quality and Safety for bedside reporting. (AHRQ, 2013)

The patient has the right to every aspect of their care and this includes being involved in the change-of-shift bedside report. The purpose of this study is to identify the benefits of bedside report and its impact on patient safety, satisfaction, and quality of care. The participants of this study were randomly selected and of varying ages. The methodology utilized in this study is a qualitative and quantitative research. The results of the study will determine the benefits of incorporating bedside report into nursing care.

Communication between nurses at report change is essential. The next nurse needs the most important information whether it is as Situation-Background-Assessment-Recommendation (SBAR) that the Institute for Healthcare Improvement (n.d.) outlines to use or in another form. The case of Rio Grande Regional Hospital Inc v. Villarreal discusses how one nurse breached the standard of care because the record reflects that from the time Hermes was given the double-edged razor until he died neither Nurse Bergado nor any other nurse checked to see how Hermes was doing in the bathroom” (Find Law for Legal Professionals, 2016). At Baylor Scott & White at All Saints, we have a policy that each patient is rounded on physically every hour.

Change of shift in the nursing profession is unique (Caruso, 2007). Information is transferred between nurses verbally and through written communication. In many facilities shift report from one shift to another involved sitting down and getting all your orders from a caredex and then talking with the previous nurse face to face going over pertinent information regarding their patients. This type of report usually happens in a report room or sometimes in the hallways or other common

The RN who is the gateway to patient care looks at the patient’s situation (current status, code status, level of uncertainty, recent changes and response to treatment…), background (comorbidities, previous episodes, current medication, family history…), assess the patient’s overall health condition and communicates vital information to all team members that are directly involved in the patient’s care during an emergency (Hood, 2014). During the course of my learning experience as a nurse, I realized that the main components in nursing profession is prioritizing information before initiating it. The use of SBAR when communicating patient’s condition to physicians, specialists, dentists, nurses and other healthcare team has improved my communication skills and has also helps physicians to determine the order of treatment for the patient thereby improving the overall patient’s

Each nurse also has specific ideas or beliefs about what information should be communicated during a verbal report. Valuable information may not be provided or may be forgotten (Casey & Wallis, 2011). Writing information down may help a nurse recall the data later, but if there is no consistent format for recording the information, it may be lost regardless. Interruptions, distractions, and the frequency of communications also may negatively effect the communication process and contribute to a nurse forgetting to share important information (Cacolice-Hildebrand, 2008). Active listening, which involves reflecting back a meaningful understanding of one’s message, is one of the most important skills in effective communication.

A weakness in communication between interdisciplinary team members can impact patient safety and health . A recent study revealed that out of all the claims analyzed , 57 percent of malpractice cases reflected miscommunication between two or more healthcare providers (Riah, 2015). In fact, the same communication failures directly linked to 1,744 deaths over the past five years (Budryk, 2016). During my clinical placement this semester I have witnessed the overwhelming number of health care team members that are involved in each patient’s care. I also take part in morning nursing rounds where all nurses are updated on every patient’s status. Transmission of permanent patient information is also relayed to all members of the health team via the patient chart .Here , interdisciplinary notes all come together to form updated health information on patients. However, although I have read interdisciplinary notes from all team members , I rarely have had the opportunity to personally communicate with members other than doctors and nurses. Personal communication allows for a team member to pass on relevant information in a timely manner without the possibility or misinterpretations. When communication is strictly done non-verbally, it is impossible to ask any questions.. This is why communication between professionals in health care is essential for patient safety and improved quality of care (Koivunen, Niemi., & Hupli,2015). There are 3 main factors that cause miscommunication

Teamwork in nursing is a little different that the teamwork of an actual team. In nursing, there is an ‘I’ in team, except here the ‘I’ stands for independent (QSEN Institute, 2015). Nurses and hospital faculty work their independent jobs, but communicate in order to give the patient the best care possible. Once again as stated before by Berman, the QSEN Institute believes that knowing your team 's strengths and weaknesses will also help you to be able to provide the best care possible.

In team nursing the responsibilities usually divided in between the personnel, so that everyone’s has its own role in patient’s care.