Capstone Project: SBAR
The transfer of patients from one department to another in healthcare and medical settings is unavoidable. The risks associated with such transfer results from the failure to hand over relevant and essential information concerning the welfare of the patients. Medical and healthcare professionals differ in the manner in which they communicate(Van et al., 2016). Failure to pass the required information during the transfer of the patients from one department to another compromise the safety of the Patients. The project explored the following PICOT
P-Patients being transferred from one department to another within a given healthcare settings.
I-The use of SBAR with is a standard form of communication among healthcare professional to ensure clarity and efficiency during hand-over communication-
C- Face to face method of communication during the hand-over communication that characterized by possible failure to transfer essential information among healthcare professionals when patients are being transferred from one department to another.
O- Improved health outcome and safety of the patients during the transfer as a result of the use of SBAR technique.
T- The technique is employed when patients are being transferred from one department to another in a hospital setting.
The patients being transferred from one department to another (P-population) can benefit from the use of SBAR (I-Intervention) to pass relevant and essential information compared to relying on face to face communication among healthcare professionals (C-comparison) since the safety of the patients is ensured (O-outcome ) during the transfer period (T-Time).
The use of standardized language in handoff communication can facilitate clear and effective communication. The use of SBAR techniques facilitates the reduction of errors associated with improper handover communication thus improving the safety of the patients.
Description of the problems
Patients can be treated potentially by different healthcare professionals in multiple setting during a period of care or an episode of disease. These settings include rehabilitations, intensive care, surgical care, emergency care, specialized outpatients or primary care. Patients will often move the care areas, treatment, and diagnosis on a systematic basis. These movements introduce as safety risks at each level to the patients(E, 2011). The hand-off communication among the care teams and between units may lead to misunderstanding or might not include all essential information(Van et al., 2016). The communication gaps created as results of these movements and shifts may cause serious breakdown of care continuity or lead to inappropriate treatment or could result to the potential harm of the patients.
The main causes of sentryhappeningsrecounted to the Joint Commission in America was a breakdown in communication in healthcare. In Australia, out of the twenty-five, communication issues caused thousands to thirty thousand preventable adverse effects, over 11% of them (WHO, 2007). Hand-over communication is therefore associated with the process of exchanging information which is specific to a patient from one healthcare professional or a caregiver to another(Taran, 2011). Various strategies are being investigated on how to improve the handover communication. Problems related to hand-over includes the education status of healthcare professionals, the lack of role models as well as the lack of healthcare system capable of promoting and rewarding health professionals who are efficient in their operations(Taran, 2011). The medicine culture, for a long time, has not positioned considerable stress involving the family and patients in healthcare provision contribute to the problems associated with hand- over communications in healthcare. Another factor that contributes significantly to communication breakdown in healthcare is the lack of enough healthcare professionals serving a growing some patients populations.
Intervention to the problem
Lesson leaned from other disciplines such as aviation and clear power industries on how to improve the hand-over communication in healthcare include the need to use a common language. Such language will be employed in communications of critical information in healthcare. Integration of informingsystems such as SBAR (Situation, Background, Assessment and Recommendation) SBAR can aid in the provision of unified communication framework for the hand-overs of the patient’s information(WHO, 2007).
SBAR is an easy to remember technique used in conversation framing especially those conversations that are considered sensitive that requires the immediate attention and action by healthcare clinicians. One of the advantages of SBAR is that it enables clarification of the required information required between the team members. It can enhance teamwork development with the mandate of fostering a culture of the safety of the patients. It stands for
- S-Situation- the present time happenings
- B-Background- The circumstances leading or surrounding the situations
- A-Assessments- determining the problem
- R-Recommendation- ways of collecting the problem
The tool enables the staff to communicate effectively and assertively thus reducing the repetition instances during the process of passing the information(Garrett, 2016).
The expected outcome
The safety of the patients when SBAR is employed is greatly improved. The techniques enable healthcare professionals to communicate in a clear manner especially when moving patients from one department to another(Friesen, White, & Byers, 2011). Additionally, healthcare professionals can anticipate the information needed when the patients are being transferred. They are therefore able to seek clarification if the need arises. Additionally, with this unified system of communication, a culture of fostering patient’s safety during the movements is well enhanced among the healthcare professionals.
Significance of the problem and its implication to the nursing
It is the responsibility of nurses among other healthcare professionals to ensure that the safety of the patients is taken into consideration during the transfer from one department to another. These movements and shifts are unavoidable. Patients will always be transferred from one area to another for diagnosis, treatment or care(Friesen, White, & Byers, 2011). Nurses and other healthcare professionals have the responsibility of ensuring effective and efficient transfer of crucial information to other professionals or family members during those transfers. Nurses have the responsibility of adopting a mechanism of communication that ensures the safety of patients during these transfers(Friesen, White, & Byers, 2011). Nurses, therefore, should adopt SBAR as a mechanism of passing hands- over to combat errors associated with the inappropriate communication.
Transfer of patients from one department to another is essential and unavoidable. Ensuring that relevant information is passed appropriately among healthcare professional is key in combating errors associated with miscommunication. The use of standardized methods of communicating during the transfer is important. SBAR is a unified mechanism that can be employed during handover. It ensures anticipation and clarity during the process of communication as well as fostering the culture of ensuring the safety of the patients among the healthcare professionals.
E, O. (2011). A systematic review of failures in handoff communication during intrahospital transfers. – PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved 16 March 2017, from https://www.ncbi.nlm.nih.gov/pubmed/21706987
Friesen, M., White, S., & Byers, J. (2011). Handoffs: Implications for Nurses. Ncbi.nlm.nih.gov. Retrieved 16 March 2017, from https://www.ncbi.nlm.nih.gov/books/NBK2649/
Garrett, J. (2016). Effective Perioperative Communication to Enhance Patient Care. AORN Journal, 104(2), 111-120. http://dx.doi.org/10.1016/j.aorn.2016.06.001
Taran, S. (2011). An Examination of the FactorsContributing to PoorCommunication Outside thePhysician-Patient Sphere. PubMed Central (PMC). Retrieved 16 March 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277343/
Van, K., Nogueira, L., Gustafson, D., Tieu, W., Averch, T., & Kim, F. (2016). The Culture of Patient Safety Practice: Systematic Review. Urology Practice. http://dx.doi.org/10.1016/j.urpr.2016.08.003
WHO. (2007). Communication during Patient Hand-overs: Patient Safety Solutions | volume 1, solution 3. www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf