Lazzari Carlo, Rabottini Marco
Department of Health Sciences, International Centre for Healthcare and Medical Education, Bristol, United Kingdom.
Front Health Serv. 2025 Aug 7;5:1380948. doi: 10.3389/frhs.2025.1380948. eCollection 2025.
The Introduction, Situation, Background, Assessment, and Recommendation (ISBAR) approach to clinical handovers assists healthcare providers in sharing information about patients within clinical teams and across health sectors while reducing information gaps and medical errors. However, despite its significance, uncertainties remain about the clear outcomes of applying ISBAR and training, especially in settings managing COVID-19 and those not dealing with the pandemic.
This review was conducted following the PRISMA guidelines. All the selected articles underwent a progressive check for bias and validity using GRADEpro GDT and RoB-2 as per Cochrane guidelines. This review utilized a meta-analysis of 29 studies and a critical narrative review of seminal articles to condense the non-numerical findings. All articles were checked for heterogeneity with the coefficient. The extracted effect size was the common language effect size (CLES), with 95% confidence intervals.
ISBAR strengthens communication skills in clinical teams, increases self-confidence and efficacy among healthcare practitioners, improves interprofessional communication, reduces medical errors, and enhances patient safety.
Our systematic review confirms that ISBAR handover improved the quality of care during the COVID-19 pandemic and non-COVID clinical practice. The limitation of this study is related to the lack of randomized controlled trials and blinding. Almost all studies were cross-sectional, which only provides information regarding associations but not causation.
临床交接班的“引言、情况、背景、评估及建议”(ISBAR)方法有助于医疗服务提供者在临床团队内部及跨卫生部门共享患者信息,同时减少信息差距和医疗差错。然而,尽管其意义重大,但对于应用ISBAR及培训的明确结果仍存在不确定性,尤其是在管理新冠肺炎的环境以及未应对该疫情的环境中。
本综述遵循PRISMA指南进行。所有选定的文章均按照Cochrane指南,使用GRADEpro GDT和RoB-2进行了偏倚和有效性的逐步检查。本综述对29项研究进行了荟萃分析,并对重要文章进行了批判性叙述性综述,以汇总非数值性研究结果。所有文章均使用I²系数检查异质性。提取的效应量为通用语言效应量(CLES),并带有95%置信区间。
ISBAR增强了临床团队的沟通技能,提高了医护人员的自信心和效能,改善了跨专业沟通,减少了医疗差错,并提高了患者安全性。
我们的系统评价证实,ISBAR交接班在新冠肺炎大流行期间及非新冠肺炎临床实践中提高了护理质量。本研究的局限性与缺乏随机对照试验和盲法有关。几乎所有研究都是横断面研究,仅提供有关关联而非因果关系的信息。