Implementing a Standardized Communication Tool in an Intensive Care Unit

Author:

Murphy Margaret1,Engel Jill R.2,McGugan Lynn3,McKenzie Rebecca4,Thompson Julie A.5,Turner Kathleen M.

Affiliation:

1. Margaret Murphy is a co-team leader for the advanced practice providers in an intensive care unit, Duke University Medical Center, Durham, North Carolina.

2. Jill R. Engel is Associate Vice President for Heart Services for Nursing, Operations & Patient Care Services, Duke University Hospital, and a clinical associate, Duke University, Durham, North Carolina.

3. Lynn McGugan is a co-team leader for the advanced practice providers in an intensive care unit, Duke University Medical Center, and a clinical associate, Duke University.

4. Rebecca McKenzie is Assistant Vice President for Perioperative Services, Duke University Hospital, and a clinical associate, Duke University.

5. Julie A. Thompson is a consulting associate, Duke University. Kathleen M. Turner is an associate professor, Duke University.

Abstract

Background Effective communication is essential in critical care settings. Use of the SBAR (Situation, Background, Assessment, Recommendation) tool has been shown to standardize and improve communication among health care providers. Local Problem This quality improvement project was designed to improve communication in an intensive care unit that lacked a standardized communication protocol. Communication practices differed greatly between nurses and advanced practice providers. As a result, patient safety was put at risk owing to incomplete, inaccurate, or delayed information when clinical concerns were reported or escalated. Methods This project used a pre-post design in which surveys were used to gather information on staff perceptions of communication and collaboration between nurses and advanced practice providers before and after an educational intervention. The 2 groups received identical education on SBAR guidelines adapted for use in the intensive care unit setting and patient safety. Results Results showed improvement in all areas of communication. Significant improvements were found on the General Perceptions subscale among advanced practice providers (P = .04) and among nurses (P = .007). In the combined study population, improvements were observed on all subscales, with significant results for the Open Communication (P = .03) and General Perceptions (P = .002) subscales. A significant increase was found in the percentage of nurses using the SBAR tool after the intervention (95%) compared with before the intervention (66%; P < .001). Conclusion Implementation of the SBAR communication tool significantly improved general perceptions of communication in this intensive care unit.

Publisher

AACN Publishing

Subject

Critical Care Nursing,General Medicine

Reference14 articles.

1. Situation, Background, Assessment, and Recommendation-guided huddles improve communication and teamwork in the emergency department;Martin;J Emerg Nurs,2015

2. SBAR, communication, and patient safety: an integrated literature review;Stewart;MedSurg Nurs,2017

3. Interventions to improve communication between nurses and physicians in the intensive care unit: an integrative literature review;Wang;Int J Nurs Sci,2017

4. American Association of Critical-Care Nurses . AACN Standards for Establishing and Sustaining Healthy Work Environments. American Association of Critical-Care Nurses website. Accessed March 21, 2020. https://www.aacn.org/nursing-excellence/standards/aacn-standards-for-establishing-and-sustaining-healthy-work-environments

5. The Joint Commission . 2020 Hospital National Patient Safety Goals. The Joint Commission website. Accessed March 21, 2020. https://www.jointcommission.org/standards/national-patient-safety-goals/hospital-2020-national-patient-safety-goals

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