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Be A Star, Use SBAR

Methodist Women’s and Children’s Hospital (San Antonio, Texas)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic

Standardizing patient handoffs

Hospital Units

Labor and Delivery 1 Central and Mother Baby Care Unit 2 West

CSI Participants

Amber Aguilera BSN, RN
Sarah Brock, RN
Karla Roque BSN, RN, CCRN
Valerie Tobias BSN, RN
Cissy Waddell, RN

Project Goals/Objectives

  1. To standardize bedside handoff/shift report using SBAR with 90 percent compliance
  2. To provide education on identifying vital patient information to 90 percent of Labor and Delivery (L&D) and Mother Baby Care (MBC) nurses
  3. To improve patient satisfaction 10 percent

Project Outcomes

  1. Increased the number of nurses who are “very confident” about understanding the importance of each part of SBAR to 90 percent
  2. Increased employees’ perception of safety during handoffs 60 percent
  3. Increased efficiency of handoff report as noted by a 5 percent decrease in the number of calls nurses made after transferring or receiving a patient

Project Overview

During patient handoffs between Labor & Delivery (L&D) and Mother Baby Care (MBC) units – as well as shift changes within the unit – vital information was being missed or forgotten, leading to delay in care, extended hospital stay and confusion. As a result, patient satisfaction was decreasing. Standardizing patient handoffs seemed like a simple way to improve communication and ensure transfer of critical patient information.

We created a group of staff nurses from L&D and MBC to tackle the problem. The group identified crucial information for reporting and revised our existing nurse’s report sheet to include those items. Then we mapped out a step-by-step process for standardizing patient transfers, including patient involvement in bedside report. During annual competency validation, we educated every unit staff member on the “why” behind the project and the how-to’s of the new process.

We conducted pre- and post-project surveys, trialed a test of change and initiated audits to ensure the new process was being followed. Overall, the project was a great success. Our staff nurses as a whole feel safer and our patients enjoy being included in bedside shift report. We plan to expand our project to surrounding units as well. Our next goal is to include the antepartum unit, since we often transfer patients there, and we would like to incorporate our report sheet in any unit that may have a patient who is pregnant.

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The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.