Miscommunication or omission of critical patient information contributes to preventable medical errors that result in 98,000 patient deaths each year. Hand-off communication process are noted as major contributors to patient safety. Improved patient care outcomes have been demonstrated by implementation of a standardized hand-off communication tool. Standardized tools that are valid and reliable are available for use, but are only effective when consistently implemented. The Situation Background Assessment Recommendation (SBAR) communication tool is designed to improve the communication between nurses and other health care providers. Internal audits have demonstrated that some of the delay in treatment and unnecessary hospitalization was due to inappropriate communication in the nursing home. The SBAR change project employed Rosswurm and Larrabee’s Model of Evidence-Based Change to train the nurses on the process of the evidence-based practice SBAR implementation. The whole process was facilitated and assessed by Rogers Diffusion of Innovation Change Theory. The project measured outcome determined that the workshop increased the nursing staff awareness and knowledge in the importance of use of SBAR during acute patient change in condition and in nurse-provider communication. The Situation, Background, Assessment, and Recommendation Knowledge Acquisition Quiz (SBARKAQ) is a 10-item questionnaire that has been demonstrated to be valid and reliable with Cronbach alpha of 0.75. Participants in the project completed the pretest before receiving the education on SBAR. This enabled pre- and post education scores to be compared for statistical difference using the Paired Samples t test. In conclusion, it is vital that the information exchanged during nurse-physician interaction is concise, clear, and adequate to ensure the continuity of care. Because nurse-physician report has been identified as ineffective due to unsuccessful communication methods, limitations of time to share information, and the inability to know if the information exchanged was understood by the receiver, implementing the SBAR format tool demonstrated clinical significance for use during nurse provider communication after hours. This proposed change project, once sustained, will improve patient outcome and decrease healthcare expenses.
