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Communication Strategies for Health Care Facilities: Use of SBAR

Provided Courtesy of RD411.com Where health care professionals go for information. Communication Strategies for Health Care Facilities: Use of SBAR. Contributed by Rachel Riddiford, MS, RD, LD Dayton Children’s Medical Center. G-1500 Review Date 1/11. What Is SBAR?. SBAR stands for:

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Communication Strategies for Health Care Facilities: Use of SBAR

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  1. Provided Courtesy of RD411.com Where health care professionals go for information Communication Strategies for Health Care Facilities: Use of SBAR Contributed by Rachel Riddiford, MS, RD, LDDayton Children’s Medical Center G-1500Review Date 1/11

  2. What Is SBAR? SBAR stands for: • Situation • Background • Assessment • Recommendation/response

  3. Why Use SBAR? • Discussions using SBAR (situation, background, assessment, and recommendation/response) can increase communication and facilitate improved patient care

  4. Why Use SBAR? Good communication encourages collaboration, fosters team work, and prevents errors Good communication=patient safety

  5. Shift change Dietitian to nurse Unit-to-unit report Nurse to physician Physician to nurse/respiratory therapy Nurse to dietitian Social worker to nurse Nurse to clinical support staff/techs Respiratory therapy to nurse Nurse to pharmacy Physician to nurse/ respiratory therapy Build Better Communication Use SBAR during hand-off communication opportunities across a facility. Examples include:

  6. SBAR: Step by Step Situation What’s going on with the patient right now? • Identify yourself • Identify the patient • State the problems concisely

  7. “S” Example (RD to RN) • I’m Rachel, the dietitian covering 3E today. • I have a concern about 363, Jones. • He was supposed to count his carbs on his lunch tray, but said no one helped him with it.

  8. “S” Example (RD to RD) • I need help covering 3E when I am off tomorrow. • I know 363 Jones will need follow-up. • He is learning carb counting and needs follow-up tomorrow.

  9. SBAR: Step by Step Background What is the background on this patient? How did we get to this point? • Review the documentation • Anticipate questions • State the relevant medical issues

  10. “B” Example (RD to RN) • He and his parents did well in their diet education, but they need practice in carb counting to increase their confidence. • I know you are busy, but hope you can help.

  11. “B” Example (RD to RN)(cont’d) • I would like to give them as much support and practical experience as possible to reduce anxiety and increase blood glucose control now and after discharge.

  12. “B” Example (RD to RD) • Patient told me that he did not get nursing assistance in carb counting at lunch today. I talked to the RN, who said she would make sure he gets help at dinner tonight. Please follow up tomorrow to find out what questions remain for him and how the evening went.

  13. “B” Example (RD to RD)(cont’d) • I have educated the patient and both parents. They are able to read labels and write a menu together, complete with carbohydrate content. • He came in with blood sugar of 650, but quickly normalized.

  14. SBAR: Step by Step Assessment What do I think the issues are? • Provide your observations and evaluations of the patient’s current state and discuss pertinent issues/concerns

  15. “A” Example (RD to RN or RD) • No family members have prior experience with type 1 diabetes. While they did well with their education, they still were weak in their confidence of putting it all together when I last talked with them.

  16. SBAR: Step by Step Recommendation/Response How do we collaborate to form a plan of action? • Discuss the plan of care to meet the patient’s immediate needs • Listen for/seek feedback to ensure that responder understands the issues

  17. “R” Example (RD to RN) • It would help the patient/parents if they could count the carbs for the nurse, rather than the nurse doing the counting at dinner tonight. • Do you think that is reasonable? • Could you please make sure the nurse that is here during dinner knows the plan?

  18. “R” Example (RD to RD) • Ideally, try to arrive right after breakfast and have patient/parents count the carbs to you, plus have them tell you how many units of insulin he will need.

  19. “R” Example (RD to RD)(cont’d) • Alternatively, try to follow up after breakfast and ask him and his parents, plus his nurse, how the carb counting went. Ask them to give you details on how they determined the carb intake. • Will this work into your current plans for the day? • Anything else you need from me?

  20. Communication Strategies Depending on the purposeof the communication, the type and the amount of information will vary.

  21. Communication Strategies Situation • Identify the problem

  22. Communication Strategies Background • Brief synopsis of patient (eg, diagnosis, date of admission, medical history)

  23. Communication Strategies Assessment • Patient’s most recent data (eg, weight changes, supplement requirement, neuro status, oral intake) • Include any changes from prior assessment

  24. Communication Strategies Recommendation/response • State what you would like to see happen • Collaboration is very important here

  25. Outcomes Positive outcomes of effective communication: • More effective interventions • Improved patient safety • Enhanced employee morale • Improved patient and family satisfaction

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