Effective and frequent communication between stakeholders, healthcare management, nursing staff, and other caregivers is essential during change since so much is happening. Accurate communication is vital at strategic, operational, and individual levels (Ting et al., 2017). Highly established verbal communication skills are necessary for lead-manager when communicating critical change process. Assertive communication is adopted to allow communicating parties to express themselves in open, direct, honest, and suitable ways that do not infringe on others’ rights (Marquis & Huston 2017). There are many practical communication tools available to facilitate communication during a change implementation process. This paper adopts SBAR as a communication tool to improve and standardize communication among stakeholders, management, nursing workers, and other caregivers when communicating change.
SBAR as a Verbal Communication Tool for Handoffs
SBAR ensures improved and standardized communication between the management and nursing staff, which is essential for error reduction and patient care quality. SBAR provides an orderly and structured approach in conveying accurate, critical, and urgent information in developing patient situations and routine handoffs (Ting et al., 2017). Handoffs involve communication between healthcare providers concerning treatment plans and care needs and happens during a change of shift or when the patient is transferred to a different unit. Study shows that the changes or switches do not always happen smoothly, leading to adverse effects and increased hospital readmissions. Approximately 80% of the medical errors are caused by ineffective communication during handoffs between care staff, creating a standardized communication tool (Marquis & Huston 2017).
The following illustration is exemplified SBAR communication for handoff in a clinical setting, for ordering a medical doctor to be called to review the condition of the patient and clarify the order concerning fluid intake.
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Describing a clinical situation is the first phase of SBAR during handoff and takes the following format. “I am (nurse name) on the ward (x) calling about (patient name) because (reason)” (Shahid & Thomas 2018). Example: Hello Dr. Johnson, this is Nurse Mary in the Pediatric section; I have an order for precise fluid intake for one of our patients called James in ward 105 with abdominal pain. I am here to update you on James’ condition and clarify the orders with you.
This entails the nurse providing a brief description of the situation’s background information (Shahid & Thomas 2018, p.7). Example: I see from the records that James was admitted yesterday, October 22, 2020, through the Emergency Department with vomiting and abdominal pain. The abdominal pain condition has worsened and, to an extent extending to the right lower quadrant. From the records, oral fluids were ordered on October 23, 2020, at 9:45 Am for the patient.
This entails providing a detailed assessment of the patient at hand. Example: I have assessed James, and I feel concerned about his condition (Shahid & Thomas 2018). The patient’s abdominal pain has increased for the last 24 hours, characterized by frequent vomiting since he was admitted.
The nurse initiating the communication should recommend the possible steps essential for improving the patient’s condition (Shahid & Thomas 2018). I recommend we should administer him intravenous fluids and keep him “nil per os (NPO).” This stage also evolves, engaging the physician on what probably could be done as part of the recommendation. For instance, can we organize for an ultrasound to dismiss appendicitis?
Communication of patient-specific health information during handoffs requires understanding and describing the patient’s current clinical condition in detail, and clinical trajectory also refers to as situational awareness. SBAR provides structured communication, ensuring that the information provided is accurate and informative.
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Marquis, B.L. & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Shahid, S., & Thomas, S. (2018). The Situation, Background, Assessment, Recommendation (SBAR) communication tool for handoff in health care–a narrative review. Safety in Health, 4(1), 7.
Ting, W. H., Peng, F. S., Lin, H. H., & Hsiao, S. M. (2017). The impact of situation-background-assessment-recommendation (SBAR) on safety attitudes in the obstetrics department. Taiwanese journal of obstetrics and gynecology, 56(2), 171-174.