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- 1. Harriet R. Sullivan-Bibee RN, BSN Kaplan University MN 510: Instructional Technology Integration Professor Mary Ann Theiss June 26, 2012
- 2. 1) Describe the meaning of SBARR 2) Discuss why SBARR is needed 3) Describe the SBARR process 4) Become familiar with the SBARR tool
- 3. “Communication errors are the root cause of almost 70% of sentinel events, and 75% of the patients involved died,” (Rodgers, 2007).
- 4. When does it happen? HAND OFF REPORT -Clinician to Physician -Clinician to clinician
- 6. 1. Communicate interactively 2. Communicate up-to-date information 3. Limit interruptions 4. Allow sufficient time to complete the hand-off. 5. Require a verification process 6. Ensure the receiver of information has the opportunity to review relevant historical data
- 7. The beginning of SBAR “SBAR is a communication format, which was initially developed by the military and refined by the aviation industry to reduce the risks associated with the transmission of inaccurate and incomplete information”,(Rodgers, 2007).
- 8. What does SBARR stand for: S-Situation B-Background A-Assessment R-Recommendation R-Read back
- 10. Name Medical record number Age Diagnosis Medication list Allergies Vital signs Lab results Advance Directive
- 11. Have I seen and assessed the patient myself before calling? Review the chart for appropriate physician to call.
- 12. Identify self, agency, and patient name What is going on with the patient that is a cause for concern. A concise statement of the problem
- 13. Admitting diagnosis and date of admission List of current medications, allergies, IV fluids, etc. Most recent vital signs Lab results: provide the date and time test was done and results of previous tests for comparison Medical history Recent clinical findings Advance Directive/code status
- 14. What are the clinician’s findings? What is the analysis and consideration of options? Is this problem severe or life threatening?
- 15. What action/recommendation is needed to correct the problem? What solution can you offer the physician? What do you need from the physician to improve the patient’s condition? In what time frame do you expect this action to take place?
- 16. Confirm what you heard. Repeat what is ordered by the physician. Reduces errors.
- 17. Standard of care Safety and Quality Not being Communication Being clear with direct. Between nurse and expectations and physician/nurse recommendations Wrong medication/ Provides safe care wrong with good outcomes procedure Sentinel event with Saves time. Physicians and poor patient nurses are less frustrated. outcomes
- 19. Conclusion Being concise and accurate with the information regarding our patients is essential to positive outcomes. Using SBARR will improve the communication between nurses and physicians.
- 20. For more information please feel free to contact me at: Harriet R. Sullivan-Bibee, B.S.N., R.N. Kaplan University Harriet Sullivan-Bibee@student.kaplan.edu
- 21. (2007). Nursing Education Perspectives SBAR for students. 28 (6), p306-306, 1/3p; (AN27779598) Delmarva foundation and the Maryland Patient safety center.(2007). Handoffs & Transitions Learning Network. Retrieved from http://www.marylandpatientsafety.org/html/learning_netwo k/hts/materials/resources/handoffs/HandoffsStrategiesChart pdf Rodgers, K.L. (2007).Using the SBAR communication technique to improve nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
- 22. Montgomery Learning college (nd). SBAR. Retrieved from http://warfieldgraphics.com/CLIENTS/SBAR/SBAR%20Worksheet%2 0Kaiser%20 ermanente.pdf Ohio Kepra (nd). Medicare quality improvement organization. SBAR communication. Retrieved from www.snjourney.com/ClinicalInfo/WrAndReport/SBAR.ppt The Toronto Rehab (2010). No SBAR: Ineffective communication. Retrieved from http://www.youtube.com/watch?v=CtdNQfKg8&feature=relmfu The Toronto Rehab (2010). SBAR: Effective communication. Retrieved from http://www.youtube.com/watch?feature=endscreen&NR=1&v=fsa EArBy2g
Editor's Notes
- #4: Rodgers, K.L. (2007, March/April).Using the SBAR communication technique to improve nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
- #5: It has been identified that hand off communication between clinicians in health care is not accurate and concise regarding patient care.
- #6: TheTorontoRehab (2010).No SBAR: Ineffective communication. Retreived from http://www.youtube.com/watch?v=CtdNQ-sfKg8&feature=relmfu
- #7: 1.) allowing and promoting questions between the giver and receiver of information. 2.) regarding care, treatment, services, condition, and recent or anticipated changes. 3.) to avoid losing or skewing the information shared. 4.) Don’t be rushed, have plenty of time to discuss the situation. 5.) repeat-backs or read-backs as appropriate. 6.)including previous care treatment protocols. Delmarva foundation and the Maryland Patient safety center.(2007). Handoffs & Transitions Learning Network. Retrieved from http://www.marylandpatientsafety.org/html/learning_network/hts/materials/resources/handoffs/HandoffsStrategiesChart.pdf
- #8: Rodgers, K.L. (2007, March/April).Using the SBAR communication technique to improve nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
- #9: (2007). Nursing Education Perspectives.SBAR for students.28 (6), p306-306, 1/3p; (AN 27779598)
- #10: This is a tool that is typically used for nurses to help provide an outline to communicate with the physician. Montgomery Learning college (nd). SBAR. Retrieved fromhttp://warfieldgraphics.com/CLIENTS/SBAR/SBAR%20Worksheet%20Kaiser%20Permanente.pdf
- #11: Before making contact with a physician or giving a hand off report be sure to have the patients information available to you.
- #12: Assess the patient prior to calling the physician, the more accurate details that can be provided the better.
- #13: Situation – This is Harriet Sullivan-Bibee RN, on 2 East. I am calling about Mr. Mitchell. I am concerned with his vital signs and his worsening condition.
- #14: Background – admitted on 6/26 diagnosis is sepsis UTI, NKA. Currently on Levaquin 500mg IV daily. Vital signs are 103 F., 120, 20, 154/90, 91% r/a. WBC-21.00 this am, blood and urine cultures are pending.Past medical history is chronic foley r/t urinary retention.Urine is cloudy with sediment.Full code.
- #15: Assessment – My findings are fever, cloudy/sediment urine, and tachycardia. No change in mental status noted. I believe the anti-biotic is resistant. The patient is not improving. I am concerned he could become septic.
- #16: Recommendation – would be what the nurse is directly asking for. Do you want blood cultures stat, I would suggest an order for Tylenol, and possibly alt this with Motrin? Do you want to change the foleycath?
- #17: Read back – the nurse would then read back the MD’s orders. “Ok, obtain blood cultures x 2 stat, give Tylenol 650mg po every 4 hrs prn temp, and alternate with Motrin 600mg po every 6hrs for a temp greater than 101.5. Thank you.”
- #19: http://www.youtube.com/watch?feature=endscreen&NR=1&v=fsazEArBy2g