Transcript G-1500 Communication Stategies for Health Care

Provided Courtesy of Nutrition411.com
Communication Strategies
for Health Care Facilities:
Use of SBAR
Contributed by Rachel Riddiford, MS, RD, LD
Updated by Nutrition411.com staff
G-1500
Review Date 1/14
What Is SBAR?
SBAR stands for:
• Situation
• Background
• Assessment
• Recommendation/response
Why Use SBAR?
• Discussions using SBAR (situation,
background, assessment, and
recommendation/response) can increase
communication and facilitate improved
patient care
Why Use SBAR? (cont’d)
• Good communication encourages
collaboration, fosters teamwork, and
prevents errors
• Good communication=patient safety
Build Better
Communication
Use SBAR during hand-off communication
opportunities across a facility. Examples include:
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/technicians
• Respiratory therapy to nurse
• Nurse to pharmacy
• Physician to nurse/
respiratory therapy
SBAR: Step by Step
Situation:
What’s going on with the patient right now?
• Identify yourself
• Identify the patient
• State the problems concisely
“S” Example
(RD/RDN to RN)
• I’m Rachel, the registered 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.
“S” Example
(RD/RDN to RD/RDN)
• 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.
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
“B” Example
(RD/RDN 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.
“B” Example
(RD/RDN 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.
“B” Example (RD/RDN
to RD/RDN)
• The 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 he may have
and how the evening went.
“B” Example (RD/RDN
to RD/RDN) (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.
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
“A” Example (RD/RDN
to RD or RD/RDN)
• 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.
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
“R” Example
(RD/RDN 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
who is here during dinner knows the
plan?
“R” Example (RD/RDN
to RD/RDN)
• Ideally, try to arrive right after breakfast
and have the patient/parents count the
carbs to you, plus have them tell you
how many units of insulin the patient
will need.
“R” Example (RD/RDN
to RD/RDN) (cont’d)
• Alternatively, try to follow up after
breakfast and ask the patient and
parents, plus the patient’s 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?
Communication
Strategies
• Depending on the purpose of the
communication, the type and the
amount of information will vary
Communication
Strategies (cont’d)
Situation:
• Identify the problem
Communication
Strategies (cont’d)
Background:
• Brief synopsis of patient (eg, diagnosis, date
of admission, medical history)
Communication
Strategies (cont’d)
Assessment:
• Patient’s most recent data (eg, weight
changes, supplement requirement,
neurological status, oral intake)
• Include any changes from prior assessment
Communication
Strategies (cont’d)
Recommendation/Response:
• State what you would like to see happen
• Collaboration is very important here
Outcomes
Positive outcomes of effective
communication:
• More effective interventions
• Improved patient safety
• Enhanced employee morale
• Improved patient and family satisfaction