Condition category
Not Applicable
Date applied
05/11/2012
Date assigned
08/11/2012
Last edited
14/01/2016
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

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 hospital’s 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

Trial website

Contact information

Type

Scientific

Primary contact

Dr Maria Engström

ORCID ID

Contact details

University of Gävle
Faculty of Health and Occupational Studies
Department of Health and Caring Sciences
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden
+46 26 64 85 00
mem@hig.se

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

N/A

Study information

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

Acronym

Study hypothesis

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

The Regional Ethical Review Board in Uppsala, 9 March 2011, ref. No. 2011/061

Study design

Quasi-experimental interventional study

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Other

Trial type

Quality of life

Patient information sheet

Not available in web format, please contact maria.randmaa@hig.se to request a patient information sheet

Condition

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

Phase

Not Applicable

Drug names

Primary outcome measures

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 trial start date

15/04/2011

Overall trial end date

01/02/2013

Reason abandoned

Eligibility

Participant inclusion criteria

Staff members working at the two anaesthetic clinics (physicians, registered nurses and licensed practical nurses)

Participant type

Patient

Age group

Adult

Gender

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.

Participant exclusion criteria

Does not meet inclusion criteria

Recruitment start date

15/04/2011

Recruitment end date

01/02/2013

Locations

Countries of recruitment

Sweden

Trial participating centre

University of Gävle
Gävle
SE-801 76
Sweden

Sponsor information

Organisation

University of Gävle (Sweden)

Sponsor details

c/o Maria Randmaa
Faculty of Health and Occupational Studies
Department of Health and Caring Sciences
Kungsbäcksvägen 47
Gävle
SE-801 76
Sweden

Sponsor type

University/education

Website

http://hig.se

Funders

Funder type

University/education

Funder name

University of Gävle (Sweden)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Funder name

County Council of Gävleborg (Sweden)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Funder name

Patient Insurance LÖF [Landstingens Ömsesidiga Försäkringsbolag] (Sweden)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Funder name

Swedish Society of Nursing [Svensk Sjuksköterskeförening] (Sweden)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

2016 results in http://www.ncbi.nlm.nih.gov/pubmed/26760400

Publication citations

Additional files

Editorial Notes

14/01/2016: Publication reference added.