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Strategy Submission

Teaching Pre-licensure Nursing Students to Communicate in SBAR in the Clinical Setting

Author:

Kimberly Silver Dunker

DNP, RN

Title:

Assistant Professor of Nursing

Coauthors:

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Institution:

University of Massachusetts Graduate School of Nursing, Worcester

Email:

kimberly.silver@umassmed.edu

Competency Categories:

Patient-Centered Care, Safety, Teamwork and Collaboration

Learner Level(s):

Faculty Development Strategies, Graduate Students, Pre-Licensure ADN/Diploma, Pre-Licensure BSN

Learner Setting(s):

Clinical Setting, Skills or Simulation Laboratories

Strategy Type:

General Strategy

Learning Objectives:

After viewing this SBAR communication video vignette, the students will be able to:  Learn how SBAR communication can be used as a simulation activity in a clinical setting to improve the quality and safety of nursing care. Analyze a patient situation then disseminate important information to physicians, mid-level providers (nurse practitioners and physician assistants) and nurses using SBAR communication.

Strategy Overview:

Online Video Vignette http://onlinetraining.umassmed.edu/sbarcommunication/ This vignette was designed for both faculty and students to learn how to communicate using SBAR.  The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to direct each student to gather and then disseminate information in a clear, concise manner utilizing the SBAR format. The vignette demonstrates to nursing students how they can gather information in clinical and put patient information together to develop a clear and concise communication strategy to speak with other health care team members.   Strategy Activity: After the students and or faculty have viewed the vignette while in clinical the student needs to practice this skill.  At some point in the clinical day, the student will actually call the clinical faculty on the telephone.  The faculty will role play a health care provider either a nurse practitioner or physician.  The student will communicate in SBAR essential information to their faculty member/healthcare provider.   The faculty/physician will give the student an order or intervention for the student to transcribe.  At the conclusion of this role-play the faculty member and student will debrief and review the verbal encounter and transcription order.  This activity will help the student to learn how to communicate in SBAR and take a verbal physicians order. Patient Centered Care Students will identify patient concerns and abnormal findings and communicate in SBAR their assessment.  (Knowledge, Attitudes) Safety Students will discover how gather essential information and be confident when communicating their findings to the physicians, nurse practitioners, nurses, and physicians assistants. (Knowledge, Attitudes) Teamwork/Communication Students will gather subjective and objective patient data, and will communicate using SBAR a concern or abnormal finding to the physicians, nurse practitioners, nurses, and physicians assistants.  (Knowledge, Skills, Attitudes)  

Submitted Materials:

SBAR-Rubric-1-1.pdf - https://drive.google.com/open?id=1X1TJtwLBHQW0fuDJ5FxebxOf6Du7zttm&usp=drive_copy

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Evaluation Description:

This activity was used in clinical as a strategy to teach SBAR and communication with physicians, nurse practitioners, nurses, and physicians assistants.  The students did not receive a grade however they demonstrated competency in this technique as evidence by:
  • Assessment of essential patient subjective and objective data to communicate.
  • Report priority data to the physicians, nurse practitioners, nurses, and physicians assistants using clear and concise method.
  • Model the use of SBAR on the clinical setting to demonstrate to other providers improved quality of care and safety of care
  • Perform the learning objectives by successfully role-playing with their faculty member, and telephone calling the faculty member who was role-playing the physician or mid level provider.
Attached is a grading rubric example that could be used by the clinical faculty member to help evaluate how the student performed during this task.  The rubric gives a score to allow the faculty to review how the student performed communicating in SBAR. Anecdotal information: This assignment was implemented among pre-licensure nursing students in an accelerated Master’s degree program. This graduate entry pathway prepares second-degree individuals as nurse practitioners. These students are finishing the clinical requirements for RN pre-licensure.  The students are in the first year of a three year graduate program for a degree as an advanced practice nurse practitioner.  During this activity they were completing the requirements for their pre-licensure RN certification. This teaching strategy integrated cognitive and psychomotor competencies from three pre-licensure nursing courses; (1) medical-surgical nursing theory (2) medical-surgical nursing clinical, and (3) nursing concepts course.  The integration of this strategy enhanced students’ ability to gain knowledge about SBAR communicate and to practice it while in clinical.  The assignment could be utilized in a variety of settings including: adult medical surgical, maternal child, pediatrics, mental health, and leadership courses. Feedback from this assignment has been positive. Students were able to identify essential information while in clinical to communicate to physicians, nurse practitioners, nurses, and physicians assistants. Thus connecting the clinical environment and course or theory component.  It has helped the students see the correlation between theory and clinical, and increased their awareness of how to enhance communication, build teamwork, and facilitate a more patient centered environment. This exercise has bridged the clinical practice environment with theory.   As a result, clinical nursing faculty have reported becoming aware of QSEN and SBAR communicate and incorporating the technique into the clinical practice environment.
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