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School of Nursing and Health Professions
Implementation of SBAR reporting in the ED
In our emergency department, reports given to the accepting floor nurse, transfer of care between emergency department nurses and nurses reporting to physicians are given in many different formats with no continuity. It has been reported that 1,744 deaths and $1.7 billion in hospital costs related to miscommunications (CRICO Strategies, 2015). With the implementation of the SBAR reporting tool, we can begin to see a decrease in miscommunications, and improve patient and staff satisfaction. The SBAR framework not only enhances the clarity and efficiency of communication between team members but also assures that each person involved knows what is going on when they come to assist in a critical situation. The SBAR technique can help to get all information related to a patient in a same page and moving in the same page (Shalini and Castelino, 2015)
San Francisco General Hospital is a Level One Trauma Center that provides trauma care, stroke and heart attack care to San Francisco and northern San Mateo county. The hospital sees approximately 3900 trauma patients annually. The hospital is also one of the few remaining safety net hospitals that is part of a city wide integrated health care system, providing primary, specialty and hospital care for the city’s vulnerable populations, (sfdph.org, 2017)
Implementation of my project required the creation of a team of volunteer nurses that would report to doctors, other nurses and the admitting floors in the SBAR format over the course of a few months. When reports were given, the nurses used the SBAR tool and throughout the study would complete surveys on how well the process was going. Nurses in the ED and on the floor, were also given a pre and post study survey on their perception of the tool and how well the SBAR tool actually worked in their setting.
Of the 10 ED nurses, 8 say they will continue to format their reports in SBAR format many stating it has changed their practice for the better. One nurse stated they would not use it, the other nurse stated that “SBAR was helpful in certain cases, in others, not so much”. Out of the 5 nurses accepting patients from the ED onto the floor, all 5 felt that SBAR was a much easier and concise format of reporting that fit their required admitting forms.
The form that I used to adapt the tool we used was the SBAR reporting and handoff tool. It is a generic form that can be found on the internet. It is the SBAR Clinical Communications Format (Appendix E).
The initial evaluation required a survey of the nurses asking their understanding of the SBAR tool, their willingness to participate and any experience with evidenced based practice. In conclusion, I found that the nurses participating had an overall positive experience with the SBAR and would either continue to use it, incorporate parts of it into their practice and/or would prefer that all nurses use the SBAR tool. Recommendations would be to expand the sample size, create leaders from the group who would be willing to encourage, teach and recruit new nurses. I found the tool was effective and appreciated by the nurses who participated. I will continue to champion for this tool to be used in our department and I wish I had more nurses to help change our culture.
CRICO Strategies. (2015). Malpractice risks in communication failures. National CBS Report Retrieved from https://www.rmf.harvard.edu/Malpractice-Data/Annual-Benchmark- Reports/Risks-in-Communication-Failures
San Francisco Department of Public Health. (2017). Quality health care and trauma services with compassion and respect. Retrieved from https://www.sfdph.org/dph/comupg/oservices/medSvs/SFGH/MoreAboutUs.asp
Shalini, Castelino, F., & T., L. (2015). Effectiveness of protocol on situation, background, assessment, recommendation (sbar) technique of communication among nurses during patients' handoff in a tertiary care hospital. International Journal of Nursing Education, 7(1), 123-127. doi:10.5958/0974-9357.2015.00025.2
carpenter, william russel, "IMPLEMENTATION OF SBAR REPORTING IN THE ED" (2017). Master's Projects and Capstones. 533.
Available for download on Thursday, May 14, 2020