Date of Graduation

Winter 12-17-2016

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Francine Serafin-dickson, MBA, BSN, CNL

Second Advisor

Elena Capella, EdD, MSN, MPA, RN, CNL, CPHQ, LNCC




Karen Richards

University of San Francisco


Effective communication is the cornerstone of providing safety and quality healthcare. However, nursing and providers often share information inequitably, as these disciplines are trained differently regarding communication. Providers are taught to be brief, accurate and focused while nurses are taught to be descriptive and holistic. These differences have led to disparity in the sharing of valuable patient information, subsequently leading to increased frustration, inefficiency, and medical errors. Multiple studies provide evidence that poor communication is a major contributor to preventable medical errors and subsequent increased hospital costs (Institute of Medicine, 1999; DeMeester, Verspuy, Monsieurs, & VanBogaert, 2013). Additionally, the gap between providers and nursing remains a strong intimidation factor for many younger nurses going into this field. These differences are inherent within units of C and D at a rural, not-for-profit, thirty-seven bed psychiatric hospital in Colorado. As a consequence, several of the six aims of healthcare quality which are safe, effective, patient centered, timely, efficient and equitable care as proposed by the Agency for Healthcare Research and Quality, 2016, have been implemented poorly. To address this gap, the goals of (1) increasing efficiency between providers and nursing; and (2) increasing reported quality of communication among staff will be realized by using a Psychiatric SBAR communication tool (PSYCH). Standardized communication tools have been shown to markedly increase the effectiveness of communication (The Joint Commission, 2012). This simple and cost effective intervention combined with the competencies of the Clinical Nurse Leader (CNL) such as educator, clinician and outcomes manager, shows promise regarding addressing several elements necessary for providing safe and quality care. The Psychiatric SBAR tool (PSYCH) can easily be further incorporated throughout the entire organization from new hire orientation to patient discharge.


Agency for Healthcare Research and Quality. (2016). The six domains of healthcare quality.

Retrieved from

De Meester, K., Verspuy, M., Monsieurs, K., & Van Bogaert, P. (2013). Clinical paper: SBAR

improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192-1196. doi: 10.1016/j.resuscitation.2013.03.016

Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from

The Joint Commission. (2012). Joint commission center for transforming healthcare releases

targeted solutions tool for hand-off communications. Retrieved from