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then explains the goal of his or her discipline, the Before calling a health-care provider, make sure
interventions, and the outcome. Effectiveness of that all the information you need is available. The
treatment, development of new interventions, and provider may want more clarification. If you are
setting new goals are discussed. The key to a suc- calling to report a drop in a patient’s blood pres-
cessful interdisciplinary conference is presenting sure, be sure to have the list of the patient’s medica-
information in a clear, concise manner and ensur- tions, laboratory results, vital signs, and blood pres-
ing input from all disciplines and levels of care sure trends, together with a general assessment of
providers, from unlicensed assistive personnel to the patient’s present status.
physicians. Sometimes when a nurse calls a physician or
health-care provider, the physician does not return
Communicating With Other Disciplines the call. It is important to document all health-care
Breakdowns in verbal and written communication provider contacts in the patient’s record. Many
among health-care providers present a major concern units keep calling logs. In the log, enter the health-
in the health-care delivery system. The Joint care provider’s name, the date, the time, the reason
Commission (www.jcaho.org) attributes a high per- for the call, and the time the health-care provider
centage of sentinel events to be related to poor com- returns the call.
munication among health-care providers. In many
SBAR
settings, nurses act as patient care managers.
Integration, coordination, and communication In response to the number of patients who die from
among all disciplines that are delivering care to a spe- or confront a preventable adverse event during
cific patient ultimately are the responsibility of the hospitalization, health-care institutions have been
nurse care manager. Nurses often find themselves in challenged to improve patient safety standards.This
the particularly advantageous position to observe the challenge forced health-care institutions to look at
patient’s responses to treatments. For example: the causes of most sentinel events within their envi-
ronments. SBAR, developed by experts at Kaiser
Mr. Richards is a 75-year-old man who was in a Permanente, one of the largest health-care systems,
motor vehicle accident with closed head trauma. is an abbreviation for Situation, Background,
He had right-sided weakness and dysphagia. The Assessment, and Recommendation (Haig, Sutton,
speech therapy, physical therapy, and social services & Whittingdon, 2006). It provides a framework for
departments were called in to see Mr. Richards. communicating critical patient information in a
A speech therapist was working with Mr. Richards systemized and organized fashion. The SBAR
to assist him with swallowing. He was to receive method focuses on the immediate situation so that
pureed foods for the second day. The RN assigned decisions regarding patient care may be made
an LPN to feed Mr. Richards. The LPN reported quickly and safely.
that although Mr. Richards had done well Although originally established to be used as an
the previous day, he had difficulty swallowing “escalation tool,” to be implemented when a rapid
today. The RN immediately notified the speech change in patient status occurs or is imminent,many
therapist, and a new treatment plan was institutions have decided to implement the method
developed. as a standard for shift report and other coordinating
communications (Haig, Sutton, & Whittingdon;
Communicating With the Health-Care www.rwjf.org, 2008). The use of the SBAR format
Provider helps to standardize a communication system to
The function of professional nurses in relation to effectively transmit needed information to provide
their patients’health-care providers is to communi- safe and effective patient care. Table 6-2 defines the
cate changes in the patient’s condition, share other steps of the SBAR communication model.
pertinent information, discuss modifications of the The implementation of SBAR as a communica-
treatment plan, and clarify orders. This can be tion technique has demonstrated such success that
stressful for a new graduate who still has some role the Institute for Healthcare Improvement recom-
insecurity. Using good communication skills and mends its use as a standard for communicating
having the necessary information at hand are help- between and among health-care providers.The Joint
ful when discussing patient needs. Commission is now requiring it as a standard for