1. Implementing SBAR into Bedside Shift Report
Student name(s) (listed alphabetically)
Senior Leadership Change Project, Fall 2015
Implementing SBAR into Bedside Shift Report
Assessment
Assessment cont.
Implementation
Summary
Problems:
Situation Background Assessment Recommendation (SBAR) is the current policy for bedside shift report (BSR) at Blessing Hospital (BH), but is not consistently being incorporated into nursing practice. Inconsistency in shift report has led to varying handoff styles and ineffective communication.
Literature Review:
SBAR is recommended to improve nurse-nurse communication and reduce time spent on irrelevant activities and information during handoff reports.2
Existing handoff reports are time-consuming, lack patient involvement and essential information, and are varied by style.4
BSR encourages patients and their families to be more proactive in their care and increases patient and family satisfaction.3
A paperwork guided SBAR form reduces handoff time by 10 minutes.1
Call light usage was reduced by 33% when BSR was initiated.1
Driving Forces:
Recognizing the need for a more consistent and effective handoff practice.
Associate Chief Nursing Officers.
Restraining Forces:
Medical-surgical nurses verbalized uncertainty and reluctance to change their current handoff practice.
Blessing Automated Records (BAR) update in December 2015 postponed coding of the SBAR form until January 2016.
Consequences of Change:
Implementation of SBAR form on medical-surgical units will bring handoff report to the bedside and create more effective communication between nurses, patients, and families.
Met with Associate Chief Nursing Officer of Professional Practice and Operations of Nursing. Discussed need to change current handoff practice. Consulted with her throughout project.
Interviewed medical-surgical nurses to gain insight on their opinions about BSR and proposed SBAR form.
Met with Clinical Informatics Supervisor to discuss steps to implement SBAR form onto BAR.
Created spreadsheet with the location of information on BAR for SBAR form coding.
Educated Associate Chief Nursing Officer of Acute Care Services and acute care nurse managers about the proposed SBAR form and its benefits.
What was Learned:
Teamwork and collaboration are vital in initiating change.
Change within an organization takes time.
Change is not always welcomed by all team members and may be met with resistance.
What we would do Differently:
Communicate with acute care managers and Clinical Informatics Supervisor earlier in the process.
Planning
Evaluation
Short Term Goals:
Create spreadsheet containing locations of BAR information needed to develop SBAR form.
Educate medical-surgical unit managers about the need for SBAR form and BSR during handoff and pilot SBAR form on medical-surgical unit.
Long Term Goals:
Implement SBAR form and BSR into handoff practice on medical-surgical units.
Nurse managers on medical-surgical units will ensure their staff is following protocol.
Nurse, patient, and family satisfaction will improve.
Evaluate the Effectiveness of the Change:
Call light usage will decrease and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores will improve, indicating increased patient and family satisfaction.
Handoff time will be reduced.
Strategies to Hardwire the Change:
Two project members will continue working to further implement this change project as nurse residents, alongside Associate Chief Nursing Officers and Spring 2016 Leadership students.
References
Cairns, L., Dudjak, L., Hoffmann, R., & Lorenz, H. (2013). Utilizing bedside shift report to improve the effectiveness of shift handoff. Journal of Nursing Administration, 43(3), doi: /NNA0b013e318283dc02
Cornell, P., Gervis, M., Yates, L., & Vardaman, J. (2014). Impact of SBAR on nurse shift reports and staff rounding. MedSurg Nursing, 23(5), Retrieved from +reports+and+staff+rounding
Gregory, S., Tan, D., Tilrico, M. Edwardson, N., & Gamm, L. (2014). Bedside shift reports: What does the evidence say? Journal of Nursing Administration, 44(10), doi: /NNA
Kerr, D., Lu, S., McKinlay, L., & Fuller, C. (2011). Examination of current handover practice: Evidence to support changing the ritual. International Journal of Nursing Practice, 17, doi: /j X x
Special Thanks: First name last name, title, department