The document discusses the use of SBAR (Situation, Background, Assessment, Recommendation) by nurses during shift change reports. It reviews research that shows SBAR improves nurse-to-nurse communication and patient outcomes by structuring the report in a consistent, focused manner. SBAR allows nurses to relay relevant information more efficiently and spend more time on patient care. The document recommends expanding the use of SBAR for all nursing shift reports to standardize communication and potentially improve safety.

1. SBAR: A solution to
shift report problems?
By Kadera Ferguson, Brittany Kurtz,
Janae McGallicher and Aimie Terry

2. Mission Moment

3. In adult medical-surgical patients, does
the use of SBAR by nurses in the shift
change report improve
communication between nurses and
patient outcomes, compared to not
using a shift change reporting tool?
PICO Question

4. Research information
● Search databases: EBSCOhost, Cochrane, Joanna Briggs
Institute, Pubmed, JSTOR
● Search terms: nurse to nurse communication, SBAR,
Communication tools, shift report, nursing shift report, handoff
communication
● Number of articles accessed: 24
● Number of articles reviewed: 8

5. S - Situation
B - Background
A - Assessment
R - Recommendation
Commonly used as a communication tool to report a change in
patient status or other concern from nursing to other departments
(physicians, pharmacy, etc.) (Cornell, Townsend-Gervis, Yates, &
Vardaman, 2013).
SBAR

6. Other Definitions
shift report - the transfer of information from one
nurse to another about patients at change of
shift in order to provide safe, quality patient
care (Poletick & Holly, 2010)
• Other names may include: handoff report,
nurse to nurse report, handover report and
sign-off

7. There are many ways in which the practice of shift report or handoff is performed in
different settings. These include: (Staggers & Blaz, 2012)
● bed side handoff
● taped verbal handoff
● verbal handoff with print supplement
● electronic templates with verbal handoff
Some of the common issues with handoff report include: (Cornell, Townsend-Gervis, Yates,
& Vardaman, 2013)
● ambiguous information (unclear, unnecessary)
● lack of key information (missing or forgotten)
● unstructured
● time consuming
Current Practice and Common Complaints

8. ● This method of handoff shift report has improved accountability and the critical
thinking approach to events(Boaro et al., 2010).
● Use of the tool helps nurses to relay information in an objective and professional
manner while increasing their ability to justify the recommendations chosen (Boaro et
al., 2010).
○ Handoff communication becomes more comprehensive and decreases human
error.
● Increased nurse confidence in relaying information (Ardoin & Broussard, 2011).
Research Findings

9. ● The nurse spent less time writing information and more time providing patient care and
critically thinking about the patient progression Cornell, Townsend-Gervis, Yates, &
Vardaman, 2014).
● SBAR decreases the overall time nurses spent on shift report, indicating a more
focused process of information transfer (Cornell, et al., 2014).
● SBAR levels the playing field for all nurses regardless of their level of experience
(Cornell, et al., 2014).
Research Findings cont.

10. ● Implementation of an SBAR shift report tool resulted in:
○ greater focus and consistency of nursing shift reports (Cornell et al., 2013).
○ increased nurse to nurse communication and decreased amount of transcribing
occurred when a print form of SBAR was provided.
● SBAR reduced adverse events and drug events (Haig, Sutton, & Whittington, 2006).
● SBAR decreases the amount of unexpected deaths (Meester, Verspuy, Monsieurs, &
Van Bogaert, 2013).
Research Findings cont.

11. ● In order to facilitate change within a unit, helpful encouragement and reminders
should be placed throughout the unit. This could include:
○ Placing SBAR posters in the nursing station
○ Adhering SBAR stickers on telephones
○ Encouraging peer practice and observation with the use of SBAR (Ardoin &
Broussard, 2011).
● An electronic SBAR tool would help decrease the amount of transcribed information
and allow for more verbal dialogue between nurses at shift report (Cornell et al.,
2013).
● Before implementing change, a pilot study with a small group of nurses should be
conducted in order to test the feasibility of using SBAR during shift handoffs (Ardoin
& Broussard, 2011).
Recommendations .

12. ● Expand the use of SBAR from simply a nurse-physician communication process to a
tool for nursing shift report (Cornell et al., 2014)
○ helps to accomplish The Joint Commission communication goals, as process
consistency and standardization are major pillars of the recommendations
(Cornell et al., 2013).
● Physicians should be educated in the use of SBAR and critical thinking to promote
better communication with nurses (Meester et al., 2013).
● Further higher level quantitative research should be conducted about using SBAR
during nurse-to-nurse shift handoffs (Staggers & Blaz, 2012).
Recommendations cont.

13. SBAR TOOLS
From http://links.lww.com/JONA/A240

14. PICO: In adult medical-surgical patients, does the use of SBAR by nurses in the
shift change report improve communication between nurses and improve patient
outcomes as opposed to not using a shift change reporting tool?
• Current practice includes a variety of shift report tools and styles, with varying levels
of effectiveness
• Research findings have supported the use of SBAR during shift handoff with the
benefits of
– organized and consistent reports
– effective use of report time
– improved nurse to nurse communication
• Recommendations based on research are to advocate for the adoption of SBAR into
clinical practice, taking into account the unique dynamics and function of each unit.
Conclusion

15. • Ardoin, K. B. & Broussard, L. (2011). Implementing handoff communication. Journal for Nurses in Staff
Development, 27 (3). http://0-dx.doi.org/.alvin.iii.com/10.1097/NND.0b013e318217b3dd
• Boaro, N., Fancott, C., Baker, R., Velji, K., & Andreoli, A. (2010). Using SBAR to improve communication in
interprofessional rehabilitation teams. Journal of Interprofessional Care, 24(1), 111-114.
http://dx.doi.org/10.3109/13561820902881601
• Cornell, P., Townsend Gervis, M., Yates, L., & Vardaman, J.M. (2013). Improving shift report focus and consistency
with the situation, background, assessment and recommendation protocol. The Journal of Nursing Administration,
43(7/8), 422-428. http://dx.doi.org/10.1097/NNA.0b013e31829d6303
• Cornell, P., Townsend Gervis, M., Yates, L., & Vardaman, J. M. (2014). Impact of SBAR on nurse shift reports and
staff rounding. MEDSURG Nursing, 23(5), 334-342. http://www.ajj.com/services/pblshng/msnj/default.htm
• De Meester, K., Verspuy, M., Monsieurs, K. G., & Van Bogaert, P. (2013). SBAR improves nurse–physician
communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192-
1196. doi:http://dx.doi.org.ezproxy.hacc.edu/10.1016/j.resuscitation.2013.03.016
References

16. • Haig, K. M., Sutton, S., & Whittington, J. (2006). National patient safety goals. SBAR: A shared mental
model for improving communication between clinicians. Joint Commission Journal on Quality & Patient
Safety, 32(3), 167-175. http://www.jcrinc.com/subscribers/journal.asp?durki=463
• Poletick, E. & Holly, C. (2010). A Systematic review of nurses’ inter-shift handoff reports in acute care
hospitals. JBI Library of Systematic Reviews. 8(4), 121-172. http://0-ovidsp.tx.ovid.com.alvin.iii.com/
• Staggers, N. & Blaz, J.(2012). Research on nursing handoffs for medical and surgical settings: an
integrative review. Journal of Advanced Nursing, 69(2), 247-262. http://dx.doi.org/10.1111/j.1365-
2648.2012.06987.x.
References Cont.