Dataset Information

Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.

ABSTRACT:

Introduction

A lack of professional communication and collaboration may be one of the main causes of medication errors. The objective was to evaluate the results of the implementation of ISBAR as a communication and safety tool in a Lithotripsy and Endourologic Unit of a tertiary public hospital.

Methods

A total of 457 patients were included in a retrospective study from 2014 to 2019. Patients were divided into two groups: group A (357 patients) in which an endourological procedure was performed before march of 2018 (without the implementation of ISBAR tool) and Group B (100 patients) with the implementation of ISBAR tool. The inclusion criteria were patients accepted for surgical intervention by anaesthesiology Department and operated in the period of the study. The variables analysed included number of procedures, global, intraoperative and postoperative complications rate, urinary infection or sepsis, NPR (FMEA), percentage of suspended surgical patients and hospital stay.

Results

The postoperative complications showed no significant differences between groups, but a trend to diminishing was seen in the complication in the group B. The sepsis reduced its incidence and it was close to significant difference. The operative time was shorter in group B 119,11min (114,63-123,59) vs 115,11min (109,63-121,67) p = 0,3. The reduction in the main postoperative complication (sepsis) explained the lower hospital stay for group B. The severe adverse events detected were reduced completely.

Conclusions

ISBAR tool was an effective patient safety tool improving quality care. To provide safe patient care and improving quality is indispensable an effective communication flow.

SUBMITTER: Gadea-Company P

PROVIDER: S-EPMC10237371 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.

Gadea-Company Patricia P Casal Angulo Carmen C Hurtado Navarro Clara C

PloS one 20230602 6

<h4>Introduction</h4>A lack of professional communication and collaboration may be one of the main causes of medication errors. The objective was to evaluate the results of the implementation of ISBAR as a communication and safety tool in a Lithotripsy and Endourologic Unit of a tertiary public hospital.<h4>Methods</h4>A total of 457 patients were included in a retrospective study from 2014 to 2019. Patients were divided into two groups: group A (357 patients) in which an endourological procedur ...[more]

PMID: 37267290

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Project description:BackgroundSituation-Background-Assessment-Recommendation (SBAR) is a tool for structuring communication between healthcare professionals. SBAR reduces medical errors, however few studies have evaluated its quality in real practice.AimsTo describe the quality of SBAR utilization by intensive care unit (ICU) nurses during phone conversations with physicians. To assess the influence of nurses' training, professional experience, and call circumstances on this quality.Study designThis observational study was conducted in the adult ICU of a university hospital in French speaking Switzerland. All consecutive telephone calls from nurses to physicians during a calendar month, were recorded. Those related to a change in patients' clinical status were selected and analysed. The quality of SBAR utilization was assessed using a pre-defined analysis grid. Scores ranged from 0 (worst quality) to 100% (best quality). Nurses' sociodemographics and training record were collected. Multiple regression was used to assess determinants of SBAR quality including nurses characteristics and level of training.ResultsWe analysed 290 phone calls, made by 99 nurses. The median SBAR quality score was 41% (interquartile range [IQR] 33-48). Quality scores varied across the four items of SBAR: Situation 88% (81-94), Background 17% (6-27), Assessment 17% (0-33), and Recommendation 33% (17-40). Factors independently associated with higher SBAR quality were age (-0.66%, p = .002, 95% CI [-1.07; -0.25]), primary language other than French (-8.40%, p = .017, 95% CI [-15.29; -1.51]), lack of ICU expertise (-9.25%, p = .013, 95% CI [-16.5;1-1.99]), and SBAR training in pre-graduate nursing education (+11.53%, p = .028, 95% CI [1.27; 22.79]).ConclusionsThe quality of SBAR utilization remains low in ICU clinical practice. Pre- and post-graduate training seem to improve its quality.Relevance to clinical practicePre-graduate mandatory training associated with multiple repetitions could improve nurses' SBAR utilization. Training using the SBAR tool should be combined with the development of nursing skills in assessment and clinical judgment.

Project description:BACKGROUND: To date, no standardized presentation format is taught to emergency medicine (EM) residents during patient handoffs to consulting or admitting physicians. The Situation-Background-Assessment-Recommendation (SBAR) is a common format that provides a consistent framework to communicate pertinent information. OBJECTIVE: The objective of this study was to describe and evaluate the feasibility of using SBAR to teach interphysician communication skills to first-year EM residents to use during patient handoffs. METHODS: An educational study was designed as part of a pilot curriculum to teach first-year EM residents handoff communication skills. A standardized SBAR reporting format was taught during a 1-hour didactic intervention. All residents were evaluated using pretest/posttest simulated cases using a 17-item SBAR checklist initially, and then within 4 months to assess retention of the tool. A survey was distributed to determine resident perceptions of the training and potential clinical utility. RESULTS: There was a statistically significant improvement from the resident scores on the pretest/posttest of the first case (P = .001), but there was no difference between posttest of the first case and pretest of the second case (P = .34), suggesting retention of the material. There was a statistically significant improvement from the pretest and posttest scores on the second case (P = .001). The survey yielded good reliability for both sessions (Cronbach alpha = 0.87 and 0.89, respectively), demonstrating statistically significant increases for the perceived quality of training, presentation comfort level, and the use of SBAR (P = .001). CONCLUSION: SBAR was acceptable to first-year EM residents, with improvements in both the ability to apply SBAR to simulated case presentations and retention at a follow-up session. This format was feasible to use as a training method and was well received by our resident physicians. Future research will be useful in examining the general applicability of the SBAR model for interphysician communications in the clinical environment and residency training programs.

Project description:BackgroundSystematic communication, such as the ISBAR (identification, situation, background, assessment, recommendation) approach, comprises a generic, transferable nontechnical skill. It can be used during the handover of patients set to undergo surgery and can be practiced in various ways, including virtual reality (VR). VR increasingly has been implemented and valued in nursing education as a positive contribution to teach students about pre- and postoperative nursing. A new nonimmersive 3D learning activity called the Preoperative ISBAR Desktop VR Application has been developed for undergraduate nursing students to learn preoperative handover using the ISBAR approach. However, the usability of this learning activity has not been studied.ObjectiveThis study aimed to investigate how second-year undergraduate nursing students evaluated the usability of the Preoperative ISBAR Desktop VR Application.MethodsThis was a qualitative study with observation and interviews. The inclusion criteria were undergraduate second-year nursing students of varying ages, gender, and anticipated technological competence. The System Usability Scale (SUS) questionnaire was used to get a score on overall usability.ResultsA total of 9 second-year nursing students aged 22-29 years participated in the study. The average score on the SUS was 83 (range 0-100), which equals a "B" on the graded scale and is excellent for an adjective-grade rating. The students expressed increased motivation to learn while working in self-instructed desktop VR. Still, a few technical difficulties occurred, and some students reported that they experienced some problems comprehending the instructions provided in the application. Long written instructions and a lack of self-pacing built into the application were considered limitations.ConclusionsThe nursing students found the application to be usable overall, giving it an excellent usability score and noting that the application provided opportunities for active participation, which was motivational and facilitated their perceived learning outcomes. The next version of the application, to be used in a randomized controlled trial, will be upgraded to address technological and comprehension issues.

Project description:BackgroundIn healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS).MethodsParticipants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n?=?229; k?=?46 teams) or for a confirmatory factor analysis (n?=?230; k?=?47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample.ResultsThe exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity.ConclusionsThe ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for leader and organizational development to improve EBP implementation.

Project description:Frequent and sensitive communication from neonatal staff is important to alleviate parental stress and to ensure that parents understand their baby's condition and progress. It also consequently empowers and involves parents in their baby's care. A lack of regular and informative communication from neonatal staff is a common reason for parental complaint. We sought to assess whether the implementation of a baby diary used as a communication tool would improve parent-staff communication and optimise the parental experience of neonatal care. In this study, parents and carers of babies on our neonatal unit were invited to complete a questionnaire to assess their level of satisfaction with communication by neonatal staff before and after the implementation of the diaries. The diary was designed to act as an aid to improve communication to parents about their baby and thereby complementing face-to face communication and encouraging parental involvement. The study design was a retrospective parental satisfaction questionnaire based on the Department of Health [1] and the National Institute for Health and Care Excellence (NICE) [2] quality standards for specialist neonatal care on communication and parental involvement (n=44, response rate 57%). Following implementation of the diary, the questionnaire was repeated on two occasions: one month post implementation (n=17, response rate 23%) and 15 months post implementation (n=44, response rate 65%). More parents in the post-intervention cohort felt they were receiving regular communication from staff, that their questions and concerns were being addressed, and felt involved in their baby's care than in the pre-intervention cohort. In addition, 100% of parents said they liked reading the diary and 94% felt it added to their understanding of how their baby was doing. Our project demonstrates an improvement in parents' satisfaction with communication from neonatal staff following the implementation of individual baby diaries. The diary is a simple, practical, and cost-effective tool to enhance communication between parents and staff in a neonatal unit.

Project description:BackgroundOrganizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC2 heuristic posits that organizational readiness stems from an organization's motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC2) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs.MethodsWe conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using "think aloud" and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey.ResultsKey recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what "better" means).ConclusionUse of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities.

Dataset Information

Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.

Introduction

Methods

Results

Conclusions

Publications

Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.

Similar Datasets

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