SBAR Communication Objectives - Home Care Information Network

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8/20/2012 Same Report, with Recommendations Dr. Smith, this is Nurse Jackie from AccentCare, calling about your patient, Ms. Jones. She was admitted to home health three days ago following a hospitalization for heart failure exacerbation. During her assessment today, I noted she has gained 3 pounds since yesterday and is feeling fatigued. She has rales in her anterior and posterior lower lung fields and 2+ pitting edema in her ankles, where previously there was none. She has taken the medications as prescribed. Would you like to increase her diuretic therapy I can assess her response tomorrow and collect any labs that you may want. What would you like to order How might the physician respond differently given this report Could This Make a Difference The Physician’s Response Dr. Smith says “That sounds like a good idea. Lets increase her HCTZ to 50mg for the next 3 days and please draw a potassium level on the third day. Keep an eye on her for the next few days and get me the results. We can decide if that is a good dose to continue.” Remember: The physician wants to make sure the patient receives appropriate care… So what was the difference this time What the physician perceived from the nurse’s report was this: “My patient is in trouble and the home health nurse has given a good report and a feasible option on how to help the patient.” 6
8/20/2012 SBAR Works The evidence in favor of SBAR communication is well documented: STAR Quality Initiative demonstrated that the use of this in home health helps reduce avoidable emergent care and hospitalizations 1 Hospital systems use SBAR as part of their core initiatives for Patient Safety 2 The Joint Commission endorses use of SBAR in care handoffs and physician report 3 Prepare Before You Call The clinician must gather all of the information needed to give the SBAR report effectively. Prior to calling the physician, follow these steps: Have I seen and assessed the patient myself before calling Has the situation been discussed with a clinical supervisor Review the chart for appropriate physician to call. Do I know the report from nurse who worked with the patient ahead of me Have available the following when speaking with the physician: • List of current medications, allergies, and any pertinent labs • Most recent vital signs • Reporting vitals/labs: provide the date of previous tests for comparison. Review the problem and potential recommendations. 7
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SBAR Communication Objectives - Home Care Information Network

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