Standardized methods of communicating between nurses, physicians and other health care givers promote patient quality and safety. Standardized communication also furthers optimal teamwork among health care providers, reduces human error, and institutes a form of high reliability system. Nurses (and nursing students) should use standardized methods to share what is important about a patient. Nursing students need to be introduced to specialized communication methods early in their nursing program.
Standardized communication improves efficiency because patient information can be discussed in a concise, complete and fairly rapid manner. SBAR stands for Situation, Background, Assessment and Recommendation.
Standardized communication bridges the gap in hand-off communication during changes in shift, patient transfers, and when changes in patient status occur. The Joint Commission on Accreditation of Hospitals has added a statement to Goal 2 in the Patient Safety Goals (2007) that states “implement a standardized approach to hand-off communications, including an opportunity to ask and respond to questions”. Patient transfers and hand-offs are areas of communication/teamwork where less than adequate communication has led to preventable harm to patients. The Institute for Healthcare Improvement has an extensive web site (http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/Tools/) which contains Techniques for SBAR Communication, Sample SBAR Communication Tools, SBAR Toolkit, and Safety Briefings (an IHI tool). There are case studies and patient scenarios which can be adopted to practice SBAR with students.
The memory cards which we created for student use include SBAR, rights of medication administration and an edited form of rapid response team patient status triggers. At present we begin distribution of the cards in the second semester clinical courses. There is also media for the students to view which illustrates the use of SBAR. The cards have been fashioned for the students as neck tags on breakaway cords, but they can also be prepared as pocket cards. Lanyards with school/ college identification can be used. Many of our collaborating clinical agencies use similar neck tags and pocket cards for graduates and resident physicians. Students will be educated to use the cards to report off, during the clinical day when changes in status are noted, and at every opportunity where concise communication is needed with team members.