September-October 2017 • Vol. 26/No. 5 297
Kathryn R. Stewart, BSN, RN, is Registered Nurse, Shock and Trauma ICU, Erlanger Health
System, Chattanooga, TN.
Kelli A. Hand, DNP, MBA, RN, is Lecturer, School of , University of Tennessee,
Chattanooga, TN.
SBAR, Communication, and Patient
Safety: An Integrated
Review
I
n the landmark Institute of
Medicine report To Err is
Human, editors Kohn, Corri –
gan, and Donaldson (2000) brought
attention to the epidemic of med-
ical errors occurring in the U.S.
healthcare system. They concluded
the root cause of these errors often
could be traced to faulty systemic
processes. Errors in communication
have been a major source of miscal-
culation and misdirection in health
care. According to The Joint Com –
mission (2015), communication
errors have been among the top
three leading root causes of report-
ed sentinel events every year since
2004. Times of patient handoff may
contribute to informational gaps
due to the frequency with which
these reports occur and the high-
stakes nature of the information
being exchanged (Staggers & Blaz,
2013).
Objective
The objective of this systematic
review is to analyze literature
addressing use of the Situation-
Back ground-Assessment-Recom –
mendation (SBAR) framework to
determine its effectiveness during
patient handoff communication
between healthcare pro viders. The
review approach allowed inclusion
of multiple variables and diverse
methodologies, making it the most
suitable method available for ana-
lyzing the literature pertaining to
SBAR’s impact on communication
and patient safety (Torraco, 2016).
Background
The Joint Commission (2008)
initially defined handoff as “the real-
time process of passing patient-spe-
cific information from one caregiv-
er to another, or from one team of
caregivers to another for the pur-
pose of ensuring the continuity and
safety of a patient’s care” (p. 65).
Despite their purpose of providing
necessary information for delivery
of safe patient care, patient hand-
offs appear to be prone to errors
related to frequent communication
barriers (Mardis et al., 2016).
Common barriers to effective hand-
off communication include the
hierarchical nature of health care,
organizational culture, differences
in the practiced communication
style of healthcare professions, lack
of a standardized process, and an
increasingly complex care environ-
ment (Daniel & Wilfong, 2014; The
Joint Commission, 2005, 2012). In
addition, the varying parties and
the large amount of complex infor-
mation included in handoff reports
frequently contribute to informa-
tional gaps and omissions in the
handoff report that can lead to sen-
tinel events and patient harm
(Staggers & Blaz, 2013).
To reduce communication errors
during handoff, SBAR was created
by U.S. Navy personnel as a method
for conveying critical information
in an effective, timely, and succinct
way (Curry-Narayan, 2013). Em –
ployed primarily in high-risk situa-
tions of the Navy’s nuclear subma-
rine industry, the SBAR communi-
cation tool enabled all users, regard-
less of the level of command, to
communicate via a common struc-
ture. Clinical staff at a Kaiser Perma –
nente organization in Colo rado
adapted the SBAR communication
template for use in health care
(Institute for Healthcare Improve –
ment, 2016). Following initial use
between nurses and physicians, the
SBAR template also has been used to
guide handoffs in the nurse-to-
nurse shift change report and inter-
professional patient reviews (Raiten
et al., 2015; Vardaman et al., 2012).
Kathryn R. Stewart
Kelli A. Hand
The SBAR (Situation-Background-Assessment-Recommendation)
tool was introduced to health care in 2002 to guide communica-
tion of patient care information. Evidence of an integrated literature
review indicates SBAR is an effective intervention for patient safety
through improved communication.
Instructions for Continuing Education Contact Hours appear on page 304.
September-October 2017 • Vol. 26/No. 5298
Introduction of the SBAR tool has
brought regularity and predictabili-
ty to handoff communications and
has been endorsed by The Joint
Commission (2012).
Methods
The combined search terms of
SBAR, communication, and patient
safety were entered into PubMed,
CINAHL Complete, and Cochrane
Library databases to find peer-
reviewed, English-language articles
published 2012-2017 that evaluated
the effect of SBAR use on patient
safety and communication between
healthcare providers. Additional
exclusion criteria included overlap-
ping articles between databases,
studies still in progress with no avail-
able results, articles describing only
the implementation process of
SBAR, articles assessing SBAR use
between non-healthcare profession-
als, and editorials. After application
of the exclusion criteria, 21 articles
were retained for this review. The
included publications were analyzed
for findings about SBAR use, com-
munication, and patient safety.
Results
Results of the empirical studies
were entered in a table to identify
recurring themes regarding SBAR
use and the effect on communica-
tion and patient safety (see Table 1).
Four primary themes were identi-
fied.
TABLE 1.
Studies and Themes
Author/Date Methods Results Setting/Sample LOE
Blom et al.,
2015
Pre/post-SBAR questionnaire
to evaluate healthcare
professionals’ communication
experiences
SBAR increased efficient oral communication
among healthcare workers (p=0.001). SBAR
perceived by healthcare professionals as an
effective and efficient way to structure patient
reports. Written comments noted SBAR use
facilitated improved patient safety.
Two 26-bed
hospital surgical
wards in southern
Sweden
Level IV
Cornell et al.,
2014
Observations of shift reports,
IDR before and after
introduction of paper SBAR
then electronic SBAR forms
Regarding shift reports: post-SBAR, time to
complete shift report decreased with paper
and electronic SBAR (p<0.01). Higher
volume of information also exchanged with
use of SBAR (p<0.01). Regarding IDR: post-
SBAR implementation, patient reviews were
more consistent and shorter (p<0.01).
Suburban hospital
in mid-southern
United States
n=36 RNs, IDR
patient reviews
Level IV
De Meester
et al., 2013
Pre/post-SBAR study using
review of patient records for
SBAR items during 48 hours
before adverse event;
questionnaires measuring
nurse-physician collaboration,
rate of SAEs performed
Post-SBAR implementation, unplanned ICU
admissions increased from 13.1/1,000 to
14.8/1,000 (p=0.001); unexpected deaths
decreased (p<0.001). No difference in
cardiac arrest team calls noted. Perception of
effective communication and collaboration
increased. Using SBAR, nurses were more
willing to call physicians. Increased
unplanned ICU admissions most likely
resulted from nurses identifying patient
changes earlier, leading to more ICU
admissions and fewer unexpected deaths.
16 medical-
surgical wards
5 ICUs (491 beds)
of Antwerp
University Hospital
(Belgium)
n=425
questionnaires,
207 SAE patient
reviews
Level IV
Fabila et al.,
2016
Pre/Post SBAR-PETS survey
measurements of perceived
sufficiency, clarity, accuracy of
communication
Proportion of personnel indicating exchanged
information was frequently or always
sufficient increased (p<0.0001). The
proportion of responses indicating received
information was concise/clear increased
70.5% (p<0.0001). Proportion of participants
who rarely or never found information
received in report differed from the following
clinical assessment increased 43.2%
(p<0.001).
16-bed unit of KK
Women’s and
Children’s Hospital
(830-beds,
Singapore)
n=52 personnel
(RNs and pediatric
intensivists)
Level IV
continued on next page
September-October 2017 • Vol. 26/No. 5 299
SBAR, Communication, and Patient Safety: An Integrated Review
TABLE 1. (continued)
Studies and Themes
Author/Date Methods Results Setting/Sample LOE
Fay-Hillier et
al., 2012
Students educated on SBAR
followed by use in simulated
setting in which they assessed
a patient then reported to each
other; post-SBAR qualitative
peer evaluation/ team
debriefing to assess effect
of SBAR on perceptions of
communication, patient safety
Peer feedback indicated students considered
simulation experience with SBAR assistive in
improving their communication and
collaboration skills. All participating students
indicated using SBAR tool for report helped
them focus on patient safety.
Drexel University
College of
and Health
Professions
(Philadelphia, PA)
n=9 nursing
students
Level IV
Joffe et al.,
2013
RCT in simulated on-call
setting: nurses contacted
physicians regarding six
adapted cases. Three cases
were handled without SBAR
(control), three with SBAR.
Communication regarding
specific situation cues and
background cues was
evaluated.
92 telephone calls reviewed. Most nurses
reported situation cues (SBAR group 88%,
control group 84%, p=0.6), but not
background cues. Fewer background cues
provided in SBAR cases (14% SBAR, 31%
control, p=0.08). Simply providing SBAR
forms did not ensure communication of key
information in after-hours telephone calls.
University of Texas
Health Science
Center
n=22 nurse-
physician pairs
Level II
Martin &
Ciurzynski,
2015
NPs, RNs conducted joint
patient assessments,
discussed findings using SBAR
structure; Huddle, SBAR, and
Communication Observation
Tool (HSCOT) and pre/post
measurements via
Collaboration and Satisfaction
About Care Decisions – PEDS
ED (CSACD) survey to assess
teamwork, communication, RN
job satisfaction
Joint patient evaluations occurred 83% of the
time with minimal interruptions; 83% of RNs
and 78% of NPs reported having great
experience in joint evaluation, SBAR huddle.
Mean communication score between RNs
and NPs improved post-SBAR with
corresponding improvements in perception of
communication (no p-values reported). RN
job satisfaction improved post-SBAR
(no p-value reported).
Pediatric
emergency
department in
academic medical
center, western
New York
n=32 personnel
(RN and NP), 36
patient encounters
Level IV
McCrory et
al., 2012
Pre/post-SBAR scoring of
simulated handoff reports of
decompensating pediatric
patients given by pediatric
interns to rapid responder; two
blinded reviewers assessed
recordings for information
inclusion, information order,
elapsed time of handoff.
Mean score of handoffs increased in post-
intervention scenarios (p<0.001); current
situational information prioritized above
background information in post-intervention
scenarios (p<0.001); duration of handoff
increased in post-intervention scenario
(p=0.004), while elapsed time from start of
handoff to time intern stated essential content
item decreased post-SBAR (p<0.001);
Pearson correlation coefficient between
reviews 0.94 (p<0.001)
Johns-Hopkins
University Hospital
Simulation Center
n=26 pediatric
interns, 52 handoff
recordings
Level IV
Mitchell et al.,
2013
Pre/post SBAR measurements
via observation and blinded
assessments of senior resident
presentations at weekly
surgical conferences using a
validated assessment tool,
faculty assessors with sufficient
interrater reliability, survey
assessments of user
satisfaction, multiple-choice
questionnaires assessing
educational outcomes of
conference attendees
Presentation quality improved significantly
post-SBAR (p=0.002), resulting in clearer
delivery of key information; user satisfaction
surveys indicated satisfaction with SBAR
structure (all scores ≥ 3 on 5-point Likert
scale); additional free-text comments
universally indicated presenters considered
SBAR format simple to use, helpful in
structuring presentations; educational
outcomes of attendees improved post-SBAR
(p<0.0002).
Oregon Health &
Science University
n=66 senior
resident
presentations/
user-surveys,
224 quality
assessments,
1,247 multiple
choice
questionnaire
responses
Level IV
continued on next page
September-October 2017 • Vol. 26/No. 5300
TABLE 1. (continued)
Studies and Themes
Author/Date Methods Results Setting/Sample LOE
Nagammal,
Nashwan,
Nair, &
Susmitha,
2017
Validated Handover
Evaluation Scale to assess
current nurse perception of
SBAR handover structure
95.1% of nurses agreed SBAR followed a
logical sequence, with 91.2% expressing
satisfaction with SBAR structure and 88%
recommending SBAR use in other areas of
the hospital. 81.4% reported quality of
information received via SBAR structure was
good and 56.9% of nurses identified
perceived reduction in communication errors
after using the SBAR structure.
National Center for
Cancer Care and
Research
Specialty Hospital
(74 beds, Qatar)
n=102 staff nurse
surveys
Level IV
Panesar,
Albert,
Messina, &
Parker, 2016
Medical record reviews of all
admitted patients during the
three phases of paper chart
documentation, EMR, and
electronic SBAR note
documentation to assess
presence and completion of
documentation. Each study
period took place 3 months
after introduction of each
phase.
During paper chart documentation phase,
22/173 charts contained event notes vs.
28/197 during EMR phase and 34/172 during
SBAR, indicating a nonstatistically significant
increase in documentation during SBAR
phase (p=0.07). The mean completeness of
documentation during paper chart
documentation phase was 2.23/4, compared
to 2.57 during EMR phase, 3.24 during
transition from EMR to SBAR phase, and 4/4
during SBAR phase (p<0.0001). Additionally,
during SBAR-only phase documentation of
notification of attending physician and
bedside nurse increased to 100%
(p=0.0001), indicating increased
communication among resident physician,
attending physician, and bedside nurse. Use
of an electronic SBAR note was associated
with increase in frequency of event
documentation. Pre-defined fields of the
SBAR note prompted residents to input
appropriate information accordingly, resulting
in increased completion of documentation.
12-bed pediatric
ICU in University
Children’s Hospital
(Stony Brook, NY)
n=542 chart
reviews (173 paper
chart phase, 197
EMR phase, 172
SBAR phase)
Level IV
Randmaa et
al., 2016
Pre/post SBAR audio
recordings and observations
assessing information recall,
interruptions, and disruptions
in-task taken in a control and
intervention group
In intervention group, information recall
increased from 43.4% pre-SBAR to 52.6%
post-SBAR (p=0.0004), compared to control
group scores of 51.3% and 52.6%
respectively (p=0.725). Structure of verbal
reports also improved significantly in
intervention group (p=0.028), but did not in
comparison group (p=0.889). Results
indicated receivers of report may remember
more when report is formatted to a
predictable structure common to all parties.
PACU in two
Swedish Hospitals
n=164 patient
handoffs
(72 personnel
members
including RNs,
anesthesiologists,
CRNAs)
Level III
Randmaa et
al., 2014
Pre-post-SBAR comparisons
of incident reports related to
communication and
measurements of staff
perception of communication
via pre/post surveys were
taken in intervention and
control groups
In intervention group, proportion of incident
reports due to communication errors
decreased from 31% to 11% (p<0.0001).
Staff perception of “between group
communication accuracy” improved
(p=0.039) as did perception of organization’s
safety climate (p=0.011).
Anesthetic clinics
in two Swedish
hospitals (type of
hospital not
specified)
n=139
(intervention),
91 (control)
Level III
continued on next page
September-October 2017 • Vol. 26/No. 5 301
SBAR, Communication, and Patient Safety: An Integrated Review
TABLE 1. (continued)
Studies and Themes
Author/Date Methods Results Setting/Sample LOE
Raymond &
Harrison,
2014
Pre/post-SBAR telephone
audits to assess SBAR use
and pre/post qualitative
questionnaire regarding
communication administered
to nurses and physicians
Telephone audit demonstrated SBAR use
increased (no p-values reported); post-SBAR
questionnaire results indicated SBAR use
improved ease of communication and
confidence, resulted in improved quality of
patient care.
75-bed NICU,
Groote Schuur
Hospital (Cape
Town, South
Africa)
n=50 telephone
audits
n=21 nurses, 17
physician
questionnaire
respondents
Level IV
Vardaman et
al., 2012
Qualitative case studies of two
hospitals implementing SBAR
via semi-structured interviews,
observation of nursing
activities, review of documents
pertaining to implementation
of SBAR
Four additional uses for SBAR identified
beyond its use as a communication tool:
schema formation (mental models impacting
response to situations, mental habits),
development of legitimacy (especially helpful
for new nurses calling physicians),
development of social capital (trust
developing from individual’s relationship
network), and reinforcement of dominant
logics (templates to guide cognition);
concluded SBAR may be valuable to
professionals outside nursing (administrators,
unlicensed personnel, other healthcare
professionals).
339-bed acute-
care suburban
hospital and 140-
bed suburban
women’s hospital
(Baptist Health
Systems, MS)
n=80 interviews
with RNs,
managers,
physicians
Level IV
Wang et al.,
2015
Pre/post SBAR workshop
questionnaire assessing
performance under each
SBAR domain, self-perception
of performance, ability in
clinical practice
Performance scores improved significantly
(p<0.01); students’ self-perceived abilities
regarding communication and SBAR also
demonstrated significant improvement
(p<0.01); 93.8% of students also indicated
they would use SBAR in future clinical
practice.
Fudan University
School of
(Shanghai, China)
n=18 master’s
degree nursing
students
Level IV
Wentworth et
al., 2012
Pre/post SBAR surveys
assessing ease of use, fit
within workflow, timeliness of
handoff, usefulness for routine
patients, perceived value,
ability to ask questions
Proportion of staff agreeing patient handover
took place between 1 and 6 minutes
increased post-SBAR (no p-value reported);
nurses also agreed SBAR tool was reliable
standard method for handing off patients
without interrupting workflow (no p-values
reported).
33-bed progressive
care unit, 6-room
electrophysiology
laboratory, 6-room
cardiac
catheterization
laboratory
n=51 nurse
surveys
Level IV
CRNA = certified registered nurse anesthetist, EMR = electronic medical record, ICU = intensive care unit, IDR = interdisciplinary
rounding, LOE = level of evidence, NICU = neonatal intensive care unit, NP = nurse practitioner, PACU = postanesthesia care unit,
RCT = randomized controlled trial, RN = registered nurse, SAE = significant adverse event, SBAR-PETS = situation-background-
assessment-recommendation pre-handover equipment handover timeout sign-out
Note: Each article graded using Melnyk’s hierarchy of evidence (Melnyk & Fineout-Overholt, 2015)
September-October 2017 • Vol. 26/No. 5302
Use of SBAR Creates a
Common Language for
Communication of Key
Patient Care Information.
When used to guide information
exchange between nurses and physi-
cians, SBAR bridges the communica-
tion gap that may exist between the
two professions due to different
communication styles (Panesar,
Albert, Messina, & Parker, 2016;
Randmaa, Martensson, Swenne, &
Engström, 2014). In addition, use of
the SBAR tool temporarily flattens
the hierarchy perceived in some
healthcare settings. This creates
more effective channels of commu-
nication be tween providers (De
Meester, Verspuy, Monsieurs, & Van
Bogaert, 2013; Vardaman et al.,
2012).
Historically, nurses and physi-
cians have been taught to communi-
cate using styles suited to the needs
and thought processes of their
respective professions (Raymond &
Harrison, 2014). Nurses as direct
caregivers tend to communicate
using a subjective, narrative style
that reflects the continuous flow of
information received in the perform-
ance of their daily responsibilities
(Westwood et al., 2012). In contrast,
physicians tend to communicate via
an objective, headline approach that
echoes the action-oriented method
of traditional medical education in
which expertise of the diagnosis and
treatment of the disease demands
quick action based on the objectivity
of current evidence (Westwood et al.,
2012). Professionals’ use of different
styles can result in miscommunica-
tion or omission of key patient care
information that may jeopardize
patient safety. The SBAR framework
combines the communication styles
of nurses and physicians, establish-
ing a method for handoff reports
that promotes effective information-
al ex change between the members of
the two professions (Panesar et al.,
2016; Raymond & Harrison, 2014).
Results of a correlational descrip-
tive study (Panesar et al., 2016)
indicated use of SBAR by nurses and
physicians creates a shared mental
model between the two professions
which leads to enhanced communi-
cation. In addition, a foundational
case study found the recommenda-
tion portion of the SBAR tool
improved the situational awareness
of physicians by allowing them to
view the patient through the eyes of
the direct caregiver (Haig, Sutton, &
Whittington, 2006). This further
enhanced patient safety and com-
munication between providers.
These findings were confirmed
by another correlational descriptive
study in which use of the SBAR tool
to guide information exchange
resulted in emphasis on situational
facts over ancillary information
and improvement of overall hand-
off communication (McCrory,
Aboum atar, Custer, Yang, & Hunt,
2012). The integration of profes-
sional communication styles in the
SBAR tool contributes to a more
holistic pro cess for communication,
adding standardization to nurses’
individualized assessment report
and increasing the situational
awareness of physicians (Haig et al.,
2006; McCrory et al., 2012).
As a communication structure
used by all healthcare professions,
the SBAR communication tool also
serves to eliminate temporarily the
perceived hierarchies of the health-
care system (De Meester et al., 2013;
Vardaman et al., 2012). With con-
sistent use in an organization, the
SBAR tool prevents the context of
handoff exchanges from being one
in which the speaker feels pressured
to edit the content of a report due
to the perceived hierarchical status
of the receiver. Using the SBAR tool,
nurses in one correlational descrip-
tive study (De Meester et al., 2013)
became more willing to contact the
attending physician earlier regard-
ing a change in patient condition;
they indicated use of the SBAR tool
eliminated their fear of “looking
stupid” (p. 1195) when speaking to
a physician with higher perceived
status. This response on the part of
nurses subsequently led to in -
creased patient transfers to inten-
sive care units (p=0.001) with a cor-
responding decrease in the number
of unexpected patient deaths
(p<0.001). Similarly, qualitative case
studies of SBAR implementation
(Vardaman et al., 2012) found nurs-
es were more comfortable commu-
nicating with physicians as a result
of developing legitimacy when
using the SBAR tool.
However, simply providing SBAR
forms does not ensure communica-
tion of pertinent information. A
randomized controlled trial (Joffe et
al., 2013) found situation cues
remained consistent in verbal
reports between disciplines (p=0.6)
while fewer background cues were
reported when the SBAR tool was
used (p=0.8). While these results
were not statistically significant,
they were consistent with previous
findings that use of SBAR leads to
an emphasis on current situational
information with less focus on
background (McCrory et al., 2012).
Use of SBAR Increases
Confidence of Speaker and
Receiver of Handoff Report.
Standardizing the format elimi-
nates the question of how to con-
duct a handoff report by giving the
speaker an established method for
communication, thus improving
his or her confidence in the ability
to provide an effective report (Ray -
mond & Harrison, 2014; Wang,
Liang, Blazeck, & Greene, 2015). In
two correlational descriptive studies
assessing the consistency of handoff
reports between nurses using SBAR,
authors concluded handoffs for-
matted according to the SBAR tem-
plate were more consistent (Cor -
nell, Townsend-Gervis, Yates, &
Vardaman, 2014; Wentworth et al.,
2012). Because the order of the
report is uniform regardless of the
profession, experience, or position
of the users, use of the SBAR tem-
plate enables the speaker and the
receiver to focus on the information
being exchanged (Fay-Hillier, Reg -
an, & Gallagher Gordon, 2012;
Randmaa, Swenne, Martensson,
Högberg, & Engström, 2016).
Consistent use of SBAR also aids
in identification and correction of
omitted information, subsequently
improving the receiver’s confidence
in the information contained in the
handoff report (Blom, Petersson,
Hagell, & Westergren, 2015). In
a quasi-experimental study by
Randmaa and colleagues (2014), use
of the SBAR framework by nurses
and physicians decreased the receiv-
er’s impression of needing to consult
the medical record to verify informa-
tion communicated in the handoff
report; the receiver felt more confi-
dent in the information provided. In
September-October 2017 • Vol. 26/No. 5 303
a pre/post survey and observational
study, Martin and Ciurzynski (2015)
found use of SBAR by nurses and
nurse practitioners in a pediatric
emergency department resulted in
more concise reports due to the
anticipated nature of SBAR. Overall,
implementation of SBAR leads to a
more concise report in which omis-
sions are identified more easily and
information is anticipated readily
(Blom et al., 2015; Martin & Ciur -
zynski, 2015).
Use of SBAR Improves
Efficiency, Efficacy, and
Accuracy of Handoff Report.
Use of the SBAR communication
template gives the handoff report a
standardized format that becomes
habitual for users, decreasing the
time on non-pertinent tasks during
a report and increasing its efficacy
(Cornell et al., 2014; Wentworth et
al., 2012). Performing a task the
same way every time facilitates
improved proficiency for the user.
In a correlational descriptive study,
implementation of the SBAR tem-
plate for use during nurse-to-nurse
shift handoff and interdisciplinary
rounds resulted in increased time
spent on shift report tasks, from
14.3 minutes pre-SBAR to 21.5 min-
utes (paper) and 25.4 minutes (elec-
tronic) post-SBAR (p<0.01). Simul -
taneously, total time to complete
the shift report decreased from an
average of 53 minutes pre-SBAR to
38.1 post-SBAR (p<0.01) (Cornell et
al., 2014). Authors also concluded
consistent use of SBAR during inter-
disciplinary rounding and nurses’
shift handoff report resulted in
more focused patient reviews and
shift reports, with an increased vol-
ume of information exchanged and
reduced time spent on non-perti-
nent information. While decreasing
the time for handoff report was not
the primary goal, increasing report
efficiency and reduced time spent
on extraneous and unnecessary
patient information allowed health-
care professionals to dedicate more
time to activities related directly to
patient care.
Consistent use of the SBAR tech-
nique also improved the accuracy,
clarity, and efficacy of information
exchanged during report (Blom et
al., 2015; Randmaa et al., 2014). The
simplicity and consistency of the
SBAR communication tool facilitates
professionals’ ability to differentiate
the information needed for safe
patient care and then convey the
information correctly (Randmaa et
al., 2014). In a survey study, use
of the SBAR tool was reported by
nurses to improve the sufficiency
(p<0.0001), clarity (p<0.0001), and
accuracy (p<0.001) of the content in
the handoff report (Fabila et al.,
2016). Use of the SBAR tool during
handoffs in a quasi-experimental
study decreased the proportion of
incident reports related to misunder-
standing, misinterpretation, or omis-
sion of information from 31% to
11% (Randmaa et al., 2014).
Likewise, another correlational de -
scriptive study showed SBAR use
resulted in improved clarity in
the delivery of key information
(p=0.002) (Mitchell et al., 2013). By
providing a standardized expecta-
tion for the structure of the handoff
report, use of the SBAR tool guides
the speaker in giving a focused, rele-
vant, factually correct report.
Use of SBAR Improves the
Perception of Effective
Communication and Is Well-
Received Among Healthcare
Staff.
The SBAR framework is consid-
ered by nurses and physicians to be
an effective method for organizing
the handoff report. In a study using
pre/post SBAR implementation
ques tionnaires to evaluate health-
care providers’ perceptions of com-
munication, Blom and co-authors
(2015) concluded introduction of
the SBAR tool resulted in improved
perceptions of communication in
nurse-to-nurse and nurse-to-physi-
cian scenarios. Implementation of
an SBAR document (SBAR-PETS) for
handoff between anesthetists and
non-anesthetist personnel in anoth-
er study also resulted in an increase
in the proportion of survey respon-
dents indicating exchanged infor-
mation was frequently or always suf-
ficient (p<0.0001) (Fabila et al.,
2016). Additionally, Nagammal,
Nashwan, Nair, and Susmitha
(2017) found 95.1% of nurses con-
sidered SBAR to follow a logical
order, with 91.2% expressing satis-
faction with the tool and 88% rec-
ommending its use for handoff.
Authors of other quasi-experimental
studies also identified the common
perception among healthcare staff
that use of the SBAR tool during
handoff increases communication
and collaboration (De Meester et al.,
2013; Martin & Ciurzynski, 2015).
These findings are clinically signifi-
cant …
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