| Primary Author: | Mary Townsend-Gervis, RN, BSN, MSA |
| Co-Principal Investigators/Collaborators: | Paul Cornell, Lauren Yates, Reynae Bennett, Barbara Cox |
| Organization: | Baptist Memorial Hospital |
Abstract
Background
The quality of communication among healthcare providers impacts patient safety and the efficiency and effectiveness of care. The SBAR protocol (Situation, Background, Assessment, Recommendation) improves nurse-physician communication, especially during urgent situations, but its use in other circumstances has not been fully explored.
Purpose
SBAR—in paper and electronic forms—was investigated as a protocol to improve nurse-to-nurse communication during multidisciplinary rounds and shift reports.
Materials & Methods
Medical/surgical nurses at a suburban acute care hospital were observed during normal working hours. Three observational cycles were conducted: baseline, paper SBAR, and electronic SBAR. During rounds, the length of reports, sequence of behaviors, and use of information sources were noted. 269 patient reviews were observed. During shift reports, tasks, tools, collaborators and location were noted using checklists on a tablet computer. 51 shift reports were recorded. Archival HCAHPS also were examined. The study was quasi-experimental using a repeated measures design, a level of evidence III.
Results
During rounds, the paper SBAR improved consistency, reduced the amount of transcribing, and improved the amount and quality of dialog. With the electronic SBAR, transcribing was further reduced and the average time to review patients decreased from 2 minutes to 58 seconds.
For shift reports, transcribing time with the paper SBAR nearly doubled—from 7.5 to 14 minutes. However, transcribing decreased to 3 minutes using the electronic version. Time in verbal communication nearly tripled with the electronic form. Shift report completion times increased from 22 to 32 minutes with SBAR. During the period of the study, communication related HCAHPS scores improved two percentage points.
Conclusion
SBAR decreased the time for rounds, but increased the time for shift reports. In both processes, reductions in transcription allowed nurses to focus more on the patient. SBAR improved nurse communication by increasing consistency and thoroughness of patient reviews. It also enabled nurses to present effectively regardless of experience.
© Improvement Science Research Network, 2011