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Table 1 Studies on SBAR communication tool for handoff in health care setting

From: Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review

Authors Year Country Study design Study characteristics Results
Haig et al [16] 2006 USA Pre- and post-intervention study Nursing staff in Bloomington, Illinois. A telephone survey of 10 nurses prior to the intervention. The intervention included an education session on SBAR tool and its implementation for handoff. Methods for collecting post-intervention data not described Increase in use of SBAR by 95%, improvement in admission medication reconciliation from mean of 72% to a mean of 88% and discharge reconciliation from a mean of 53% to a mean of 89%, and reduction in adverse events from 89.9 per 1000 patient days to 39.96 per 1000 patient days
Compton et al [51] 2012 USA Survey Baylor Health Care System initiated a campaign to implement SBAR and train staff in SBAR techniques across 13 hospitals. 156 nurses interviewed after implementation of SBAR package with the nurse audit tool 97.4% nurses had been educated about SBAR and 58.3% used SBAR for critical communication only. 73% of nurses demonstrated good or high proficiency. Among the nurses who did not use SBAR, the leading reason was lack of comfort with SBAR. 78% of physicians reported they received adequate information from nurses regarding patient condition
Meester et al [53] 2013 Belgium Pre- and post-intervention study 16 hospital ward nurses of Antwerp University Hospital were trained to use SBAR to communicate with physicians in cases of deteriorating patients. Patient records were checked for SBAR items up to 48 h before a SAE. There was increase in the use of all 4 components of SBAR by 34%, total score on the questionnaire increased in nurses ({from 58 (range 31–97) to 64 (range 25–97)}; p < 0.001), the number of unplanned in ICU admissions increased ((from 13.1/1000 to14.8/1000) admissions; relative risk ratio = 50%; 95% CI 30–64; p = 0.001) and unexpected deaths decreased from 0.99/1000 to 0.34/1000 admissions; RRR = − 227%; 95%CI − 793 to − 20; NNT1656; p < 0.001)
Wong et al [54] 2017 Canada Retrospective chart review Chart review of all ICU transfers from General Internal Medicine (GIM) wards of Toronto General Hospital Out of a total of 615 messages for 179 of the 236 patients, 93 (39%) patients had a CM in the 48 h prior to ICU transfer. 13 patients (17%) did not have RRT activation prior to transfer to ICU and 63 (83%) patients had delayed RRT activation after the CM. In the subgroup of 63 patients with delayed RRT activation, the only significant correlation (p = 0.047) with in-hospital survival was the number of SBAR components in the CM.
Fabila et al [37] 2016 Singapore Prospective interventional study A total of 52 CICU personnel participated in the study which include 7 pediatric consultants, 1 rotating pediatric registrar, and 44 nurses working in shifts at KK Women’s and Children’s Hospital (KKH) There was a significant increase in the proportion of nurses who indicated that information transfer during verbal face-to-face handover was frequently sufficient, as compared to the pre-intervention phase (95.5 vs. 31.8%; difference 63.7%; 95% CI 51.4–81.8%; p < 0.0001). Overall, the perceived usefulness of SBAR document during handovers significantly increased by about 33.0% (95% CI 15.0–53.0%; p = 0.0004).
Funk et al [56] 2016 USA Pre- and post-intervention study 52 pre-implementation handovers and 51 post-implementation handovers were observed at PACU of Duke University Medical Center There was a statistically significant increase in the percentage of use of ISBARQ items (p < 0.001) and provider’s satisfaction (p < 0.01) from pre-implementation to post-implementation and no significant change in duration of handoff (mean = 5.80 ± 3.80 min) to post (mean = 6.80 ± 2.30 min), p = 0.15.
Panesar et al [42] 2016 USA Prospective study 84 patient events were recorded from 542 admissions to the pediatric intensive care unit of Stony Brook Children’s Hospital. 3 time periods were studied: (1) paper documentation only, (2) electronic documentation, and (3) electronic documentation with SBAR template. There was an increase in the frequency of critical patient event notes but not statistically significant (p = .07) and improvement in quality scores significantly from paper documentation to electronic SBAR-template notes. Moreover, 100% documentation of nurse and attending physician communication was achieved during electronic SBAR note period.
Ting et al [38] 2017 Taiwan Pre- and post-intervention study The SBAR course was offered as a 1-h session by obstetricians annually at Far Eastern Memorial Hospital from 2012 to 2015. All nurses were asked to answer the Safety Attitudes Questionnaire (SAQ) before and after the intervention. 6 safety dimensions of SAQ were assessed which include teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and working conditions 29 nurses completed the pre-intervention survey, 34 completed the first post-intervention survey, and 33 completed the second post-intervention survey. There was improvement in the value ratings for teamwork climate (p = 0.002), safety climate (p = 0.01), job satisfaction (p = 0.002), and working condition (p = 0.02).
McCrory et al [57] 2012 USA Pre- and post-intervention study Each of the 26 pediatrics interns at John Hopkins University reviewed a scenario involving a decompensating pediatric patient and gave a simulated handoff to a responder. A didactic session on ABC-SBAR was given, then performed a second handoff using another scenario. A total of 52 handoffs were included for analysis. The mean score of handoffs increased after ABC-SBAR training (from 3.1/10 to 7.8/10; p < 0.001). Handoff report of the airway, breathing, and circulation increased (from 35 to 85%; p = 0.001) after the training, the information was also shared earlier (25 vs. 5 s; p < 0.001) in post-intervention period. Total handoff duration was increased (pre-intervention 29 s vs. post-intervention 36 s, p = 0.004).
Townsend- Gervis M et al [23] 2014 USA Prospective study 111 nurses participated from 3 medical and surgical unit of Baptist Memorial Health Care Corporation .Nurses used SBAR in a variety of circumstances, including shift reports and physician rounds (both paper and electronic copy of SBAR was available for patient presentation) Over the 3-year period, Foley compliance improved (from 78 to 94%; p < 0.001) and re-admissions decreased (from 14.5 to 2.1%; p < 0.001), both significant. Patient satisfaction trended positively but was not significant
Vanderman et al [60] 2012 USA Qualitative case study Nurses had received training in SBAR for use primarily in communication with physicians. Data were collected from 80 semi-structured interviews with nurses (n = 66), nurse manager (n = 9), and physicians (n = 5), and observations were made on nursing, other hospital activities, and documents that related to the implementation of the SBAR protocol. SBAR tool has impact on schema formation (quick decision making when bombarded with load of information), development of legitimacy, development of social capital (networking), and reinforcement of dominant logics in addition to improvement in nurses and physician communication
Renz SM et al [61] 2013 USA Pre- and post-intervention study 137 bed skilled nursing home, part of a faith-based continuing care retirement community in suburban Pennsylvania.
40 nurses participated in pre-intervention phase and 32 participated in post-intervention phase
87.5% of nurses found SBAR tool useful to organize information when communicating to medical providers. 78% (n = 51) had complete documentation, while the remaining 22% (n = 14) had some missing documentation. The physician reported improvement in the quality of nurse-physician communication related to change in resident condition after implementation of the project