Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences?
| ISRCTN | ISRCTN37251313 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN37251313 |
| Secondary identifying numbers | N/A |
- Submission date
- 05/11/2012
- Registration date
- 08/11/2012
- Last edited
- 14/01/2016
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Several studies have shown that communication and collaboration problems are one of the most common causes of medical error. To make communication more effective and consistent, the communication tool SBAR (Situation, Background, Assessment, Recommendations) is used in high-risk organizations and it has also been introduced in health care. SBAR is thought to create conditions for correct exchange of information, encourage dialogue and is recommended for care by World Health Organization (WHO) for use in care to increase patient safety. The aim of the present study is to examine staff members communication, collaboration and safety attitudes in anaesthesia and intensive care before and after introduction of SBAR.
Who can participate?
Staff members (physicians, registered nurses and licensed practical nurses) in anaesthetic clinics at two hospitals in central Sweden.
What does the study involve?
The study involves one group in which the intervention SBAR is implemented (the anaesthetic department at one of the two hospitals) and one comparison group (the other hospitals anaesthetic department). The intervention includes an in-house training course (2.5 hours of lecture, role-play and a later follow-up) and information material describing SBAR. Data were collected before the implementation of SBAR and will be collected again after implementation of SBAR to measure the effect of the communication tool SBAR. Data collection is being performed using questionnaires and observations. Various questionnaires are used to study staffs perception of relationships and communication within the clinic, staffs safety attitudes, staffs perceptions of their psychological empowerment at work (meaning, competence, self-determination and impact ). To study communication during handovers in the post anaesthesia care unit (PACU) a study protocol is being used during observations (based on earlier research) together with audio tape-recording of the handovers and the patients anaesthetic records. The handovers structure, content, omission of data, interruptions and the receivers retention of information is being studied. At each handover the receiver is asked to reproduce the information during the verbal handover, and this is audio-taped. Interviews with staff will also be performed and incident reports will be examined.
What are the possible benefits and risks of participating?
The possible benefit is that the communication tool SBAR will ease verbal handovers and improve staff members perception of communication within and between different professions and collaboration. Furthermore it is possible that medical errors will decrease.
Observations and audio-taping of handovers, among other methods, are being used to collect data and there is a potential risk of participants experiencing discomfort.
Where is the study run from?
University of Gävle, Sweden and the County Council of Gävleborg, Sweden.
When is the study starting and how long is it expected to run for?
The study started in April 2011 and is expected to run until February 2013 (data collection).
Who is funding the study?
University of Gävle, County Council of Gävleborg, Patient Insurance LÖF (Landstingens Ömsesidiga Försäkringsbolag) and Swedish Society of Nursing (Svensk Sjuksköterskeförening).
Who is the main contact?
Dr Maria Engström
mem@hig.se
Contact information
Scientific
University of Gävle
Faculty of Health and Occupational Studies
Department of Health and Caring Sciences
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden
| Phone | +46 26 64 85 00 |
|---|---|
| mem@hig.se |
Study information
| Study design | Quasi-experimental interventional study |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Other |
| Study type | Quality of life |
| Participant information sheet | Not available in web format, please contact maria.randmaa@hig.se to request a patient information sheet |
| Scientific title | Staff members perception of communication, safety attitudes and verbal handovers before and after implementation of SBAR in anaesthesia and intensive care: a quasi-experimental study |
| Study objectives | Implementation of the communication tool SBAR (Situation, Background, Assessment, Recommendations) will improve staff members perception of communication within and between different professions, safety attitudes as well as their perception of psychological empowerment. Furthermore, it will improve the structure of verbal handovers, decrease handover duration and increase retention of information among receivers of handovers. |
| Ethics approval(s) | The Regional Ethical Review Board in Uppsala, 9 March 2011, ref. No. 2011/061 |
| Health condition(s) or problem(s) studied | Anaesthetic clinics at two hospitals in central Sweden |
| Intervention | The study includes an intervention group in which SBAR is introduced and a control group. The intervention includes an in-house training course (2.5 hours of lecture, role-play and a later follow-up) and implementation of the communication tool SBAR at one of the two anaesthetic clinics. Information material describing SBAR is distributed to all staff in the intervention group, who receive a plastic card describing the SBAR structure that is to be used during handovers. During the SBAR implementation period, measures are conducted to follow the implementation. Monthly structured telephone interviews with a random sample of ten staff are performed each month during the implementation period and the staff members perform observations of each others to measure whether and how SBAR is used. Results of these measures are used as feedback to the intervention group. |
| Intervention type | Other |
| Primary outcome measure | 1. Staff members perception of relationships and communication within the clinic including the factors within-group communication openness, between-group communication openness, within-group communication accuracy, between-group communication accuracy and communication timeliness. Staff members safety attitudes in the clinic including the factors: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management and working condition. 2. Percent memorized information sequences by the receiver of handover, duration and structure of the handovers in PACU. 3. In addition, staff members experiences of and reflections on communication within and between professions and collaboration during verbal handovers, the communication tool SBAR and their experiences of and reflection on patient safety in relation to verbal handovers will be investigated in a study using a qualitative approach. |
| Secondary outcome measures | 1. Staff members perceptions of psychological empowerment including the factors meaning, competence, self-determination and impact. 2. Incident reports before and after implementation of SBAR |
| Overall study start date | 15/04/2011 |
| Completion date | 01/02/2013 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | A total of 387 staff (intervention group 242 participants and comparison group 145 participants). In the study using qualitative approach approximately 24 informants will be included. |
| Key inclusion criteria | Staff members working at the two anaesthetic clinics (physicians, registered nurses and licensed practical nurses) |
| Key exclusion criteria | Does not meet inclusion criteria |
| Date of first enrolment | 15/04/2011 |
| Date of final enrolment | 01/02/2013 |
Locations
Countries of recruitment
- Sweden
Study participating centre
SE-801 76
Sweden
Sponsor information
University/education
c/o Maria Randmaa
Faculty of Health and Occupational Studies
Department of Health and Caring Sciences
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden
| Website | http://hig.se |
|---|---|
"ROR" |
https://ror.org/043fje207 |
Funders
Funder type
University/education
No information available
No information available
No information available
No information available
Results and Publications
| Intention to publish date | |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not provided at time of registration |
| Publication and dissemination plan | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 01/03/2016 | Yes | No |
Editorial Notes
14/01/2016: Publication reference added.
