SBAR Communication in Nursing Shift Report

Evidence Based Practice presentation on the use of SBAR in nursing shift report.

1. SBAR: A solution to shift report problems? By Kadera Ferguson, Brittany Kurtz, Janae McGallicher and Aimie Terry

2. Mission Moment

3. In adult medical-surgical patients, does the use of SBAR by nurses in the shift change report improve communication between nurses and patient outcomes, compared to not using a shift change reporting tool? PICO Question

4. Research information Search databases: EBSCOhost, Cochrane, Joanna Briggs Institute, Pubmed, JSTOR Search terms: nurse to nurse communication, SBAR, Communication tools, shift report, nursing shift report, handoff communication Number of articles accessed: 24 Number of articles reviewed: 8

5. S - Situation B - Background A - Assessment R - Recommendation Commonly used as a communication tool to report a change in patient status or other concern from nursing to other departments (physicians, pharmacy, etc.) (Cornell, Townsend-Gervis, Yates, & Vardaman, 2013). SBAR

6. Other Definitions shift report - the transfer of information from one nurse to another about patients at change of shift in order to provide safe, quality patient care (Poletick & Holly, 2010) Other names may include: handoff report, nurse to nurse report, handover report and sign-off

7. There are many ways in which the practice of shift report or handoff is performed in different settings. These include: (Staggers & Blaz, 2012) bed side handoff taped verbal handoff verbal handoff with print supplement electronic templates with verbal handoff Some of the common issues with handoff report include: (Cornell, Townsend-Gervis, Yates, & Vardaman, 2013) ambiguous information (unclear, unnecessary) lack of key information (missing or forgotten) unstructured time consuming Current Practice and Common Complaints

8. This method of handoff shift report has improved accountability and the critical thinking approach to events(Boaro et al., 2010). Use of the tool helps nurses to relay information in an objective and professional manner while increasing their ability to justify the recommendations chosen (Boaro et al., 2010). Handoff communication becomes more comprehensive and decreases human error. Increased nurse confidence in relaying information (Ardoin & Broussard, 2011). Research Findings

9. The nurse spent less time writing information and more time providing patient care and critically thinking about the patient progression Cornell, Townsend-Gervis, Yates, & Vardaman, 2014). SBAR decreases the overall time nurses spent on shift report, indicating a more focused process of information transfer (Cornell, et al., 2014). SBAR levels the playing field for all nurses regardless of their level of experience (Cornell, et al., 2014). Research Findings cont.

10. Implementation of an SBAR shift report tool resulted in: greater focus and consistency of nursing shift reports (Cornell et al., 2013). increased nurse to nurse communication and decreased amount of transcribing occurred when a print form of SBAR was provided. SBAR reduced adverse events and drug events (Haig, Sutton, & Whittington, 2006). SBAR decreases the amount of unexpected deaths (Meester, Verspuy, Monsieurs, & Van Bogaert, 2013). Research Findings cont.

11. In order to facilitate change within a unit, helpful encouragement and reminders should be placed throughout the unit. This could include: Placing SBAR posters in the nursing station Adhering SBAR stickers on telephones Encouraging peer practice and observation with the use of SBAR (Ardoin & Broussard, 2011). An electronic SBAR tool would help decrease the amount of transcribed information and allow for more verbal dialogue between nurses at shift report (Cornell et al., 2013). Before implementing change, a pilot study with a small group of nurses should be conducted in order to test the feasibility of using SBAR during shift handoffs (Ardoin & Broussard, 2011). Recommendations .

12. Expand the use of SBAR from simply a nurse-physician communication process to a tool for nursing shift report (Cornell et al., 2014) helps to accomplish The Joint Commission communication goals, as process consistency and standardization are major pillars of the recommendations (Cornell et al., 2013). Physicians should be educated in the use of SBAR and critical thinking to promote better communication with nurses (Meester et al., 2013). Further higher level quantitative research should be conducted about using SBAR during nurse-to-nurse shift handoffs (Staggers & Blaz, 2012). Recommendations cont.

13. SBAR TOOLS From http://links.lww.com/JONA/A240

14. PICO: In adult medical-surgical patients, does the use of SBAR by nurses in the shift change report improve communication between nurses and improve patient outcomes as opposed to not using a shift change reporting tool? Current practice includes a variety of shift report tools and styles, with varying levels of effectiveness Research findings have supported the use of SBAR during shift handoff with the benefits of organized and consistent reports effective use of report time improved nurse to nurse communication Recommendations based on research are to advocate for the adoption of SBAR into clinical practice, taking into account the unique dynamics and function of each unit. Conclusion

15. Ardoin, K. B. & Broussard, L. (2011). Implementing handoff communication. Journal for Nurses in Staff Development, 27 (3). http://0-dx.doi.org/.alvin.iii.com/10.1097/NND.0b013e318217b3dd Boaro, N., Fancott, C., Baker, R., Velji, K., & Andreoli, A. (2010). Using SBAR to improve communication in interprofessional rehabilitation teams. Journal of Interprofessional Care, 24 (1), 111-114. http://dx.doi.org/10.3109/13561820902881601 Cornell, P., Townsend Gervis, M., Yates, L., & Vardaman, J.M. (2013). Improving shift report focus and consistency with the situation, background, assessment and recommendation protocol. The Journal of Nursing Administration, 43 (7/8), 422-428. http://dx.doi.org/10.1097/NNA.0b013e31829d6303 Cornell, P., Townsend Gervis, M., Yates, L., & Vardaman, J. M. (2014). Impact of SBAR on nurse shift reports and staff rounding. MEDSURG Nursing, 23 (5), 334-342. http://www.ajj.com/services/pblshng/msnj/default.htm De Meester, K., Verspuy, M., Monsieurs, K. G., & Van Bogaert, P. (2013). SBAR improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84 (9), 1192-1196. doi: http://dx.doi.org.ezproxy.hacc.edu/10.1016/j.resuscitation.2013.03.016 References

16. Haig, K. M., Sutton, S., & Whittington, J. (2006). National patient safety goals. SBAR: A shared mental model for improving communication between clinicians. Joint Commission Journal on Quality & Patient Safety, 32 (3), 167-175. http://www.jcrinc.com/subscribers/journal.asp?durki=463 Poletick, E. & Holly, C. (2010). A Systematic review of nurses’ inter-shift handoff reports in acute care hospitals. JBI Library of Systematic Reviews. 8 (4), 121-172. http://0-ovidsp.tx.ovid.com.alvin.iii.com/ Staggers, N. & Blaz, J.(2012). Research on nursing handoffs for medical and surgical settings: an integrative review. Journal of Advanced Nursing, 69 (2), 247-262. http://dx.doi.org/10.1111/j.1365-2648.2012.06987.x. References Cont.