AACN News—November 2008—Practice

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Vol. 25, No. 11, NOVEMBER 2008


Practice Resource Network

SBAR is a communication tool that can be used in a variety of situations. It can be used when speaking with a physician about a patient, with your department manager when expressing a concern in your unit, in e-mail communications, and in status reports of committees you are working with.

Situation

My hospital is starting to implement SBAR. I know what it means, but it seems very cumbersome to use when speaking with a physician.
I don’t understand how to use it and what it will help me do. What do you advise?

Background

Communication problems are at the heart of most patient safety issues and errors. If you are like me, it seems like we are communicating pretty well and wonder why we need to learn a new way of communicating.

Assessment

We have multiple demands on our time and are constantly multitasking even in the most complex situation. Sometimes when speaking with a physician about a specific situation we also will be watching the monitor, looking at the computerized medical record and listening to the telephone ring in the nurse’s station. It can be difficult to stay focused and provide all the critical information that is needed to safely care for our patients. Our patients need to have us communicate clearly and efficiently with physicians and other healthcare providers to ensure they receive the care they need. Additionally, there are times when physicians don’t respond the way we expect, most likely because they are not getting all the information they need or want to help them make decisions.

Recommendation

SBAR is relatively new to healthcare, but it is a communication tool used by the U.S. Navy nuclear submarine program and the airline industry. Implementing SBAR communications can be difficult. It is true that physicians have a different way of presenting/receiving data. If you listen to two physicians discussing a patient, you will notice there are very specific things they do to get what they need. They have years of presenting patient data on daily rounds during their residencies, so they are well practiced at providing the key information that will ensure patients get what is needed.

Available Tools

1. The Arizona Hospital and Healthcare Association (AHHA) has created a tool kit for implementing SBAR that answers the top 12 frequently asked questions about SBAR, for example:
• Will it take too much time to format the information into SBAR? I need to contact the physician now.
• Sometimes it’s difficult to know the difference between background information and assessment. How do I differentiate?
• What do I do if a physician gets upset that I’ve made a recommendation about what I think is needed?

AHHA provides the answers to these questions as well as education and training tools, templates, practice scenarios and policy and procedure templates. http://www.azhha.org/patient_safety/sbar.aspx

2. The Department of Defense has a program titled Team STEPPS. This program includes a comprehensive collection of ready-to-use training materials and educational programs to integrate teamwork and communication strategies to enhance patient safety and performance in your healthcare system.

3. The Institute for Healthcare Improvement ( IHI) has a downloadable tool kit available.
http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/Tools/ SBARTechniqueforCommunicationASituationalBriefingModel.htmh

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Jan. 1 Is the Deadline to Apply for These AACN Nursing Research Grants

Small Grants

AACN Clinical Inquiry Grant

Five awards up to $500 each are available for projects that directly benefit patients and/or families. Interdisciplinary projects are especially invited. The principal investigator must be currently employed in a clinical setting and directly involved in patient care.

AACN End-of-Life/Palliative Care Small Projects Grant

One award up to $500 is available for a project that focuses on patients of all ages, patient education, staff development, CQI projects, outcomes evaluation projects or small clinical research studies. A broad range of topics may be addressed including bereavement, communication issues, caregiver needs, symptom management, advance directives and life support withdrawal.

AACN Evidence-Based Clinical Practice Grant

Three awards up to $1,000 each for projects focusing on research utilization studies, CQI projects or outcome evaluation studies. Collaborative projects are encouraged and may involve interdisciplinary teams, multiple nursing units, home health, sub-acute and transitional care, other institutions and community agencies.

Large Grants

AACN Mentorship Grant

One award up to $10,000 to provide research support for a novice researcher, with limited or no research experience, who will act as the principal investigator for the study. The study must be directed by a mentor with strong research experience in the area of proposed investigation. The mentor can be an AACN member; however, it is not a requirement for funding. The mentor may not be a mentor or an AACN Mentorship Grant in two consecutive years.

AACN Critical Care Grant

One award up to $15,000 for a study relative to acute and critical care nursing and focused on one or more of AACN’s research priorities.
To find out more about AACN’s research priorities and research grant opportunities, visit the Research area of the AACN Web site, www.aacn.org > Research > Grants, or e-mail research@aacn.org.

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