Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
Resuscitation. 2013 Sep;84(9):1192-6. doi: 10.1016/j.resuscitation.2013.03.016. Epub 2013 Mar 26.
The Joint Commission International Patient Safety Goal 2 states that effective communication between health care workers needs to improve. The aim of this study was to determine the effect of SBAR (situation, background, assessment, recommendation) on the incidence of serious adverse events (SAE's) in hospital wards.
In 16 hospital wards nurses were trained to use SBAR to communicate with physicians in cases of deteriorating patients. A pre (July 2010 and April 2011) and post (June 2011 and March 2012) intervention study was performed. Patient records were checked for SBAR items up to 48 h before a SAE. A questionnaire was used to measure nurse-physician communication and collaboration.
During 37,239 admissions 207 SAE's occurred and were checked for SBAR items, 425 nurses were questioned. Post intervention all four SBAR elements were notated more frequently in patient records in case of a SAE (from 4% to 35%; p<0.001), 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 intensive care unit (ICU) admissions increased (from 13.1/1000 to 14.8/1000 admissions; relative risk ratio (RRR)=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; NNT 1656; p<0.001). There was no difference in the number of cardiac arrest team calls.
After introducing SBAR we found increased perception of effective communication and collaboration in nurses, an increase in unplanned ICU admissions and a decrease in unexpected deaths.
国际联合委员会患者安全目标 2 指出，医护人员之间需要改善有效沟通。本研究旨在确定 SBAR（情况、背景、评估、建议）对医院病房严重不良事件（SAE）发生率的影响。
在 16 个医院病房中，护士接受了使用 SBAR 与病情恶化的患者的医生进行沟通的培训。进行了一项前瞻性（2010 年 7 月至 2011 年 4 月和 2011 年 6 月至 2012 年 3 月）干预研究。在发生 SAE 之前的 48 小时内，检查患者记录以获取 SBAR 项目。使用问卷测量护士与医生之间的沟通和协作。
在 37239 例住院患者中，共发生 207 例 SAE，检查了 SBAR 项目，对 425 名护士进行了询问。干预后，在发生 SAE 的情况下，患者记录中更频繁地记录了四个 SBAR 要素（从 4%到 35%；p<0.001），护士的问卷总分增加（从 58（范围 31-97）到 64（范围 25-97）；p<0.001），未计划转入重症监护病房（ICU）的人数增加（从每 1000 例 13.1 例增加到每 1000 例 14.8 例；相对风险比（RRR）=50%；95%置信区间 30-64；p=0.001），意外死亡人数减少（从每 1000 例 0.99 例减少到每 1000 例 0.34 例；RRR=-227%；95%置信区间 -793 至 -20；NNH1656；p<0.001）。心脏骤停小组的呼叫次数没有差异。
引入 SBAR 后，我们发现护士对有效沟通和协作的感知增强，未计划转入 ICU 的人数增加，意外死亡人数减少。
