Improving Handoffs

Patient or caregiver panics due to delirium, uncontrolled symptoms, fall etc.

SBAR

• Give verbal report to the ED
• Situation
• Background
• Assessment
• Recommendation

Situation
This is Kathy from Old Colony Hospice. Mr. Jones , an 88 year old home hospice patient, was found on the floor by his daughter, Emily, who called 911. No obvious injuries.

Background
Patient has End Stage Liver Disease with increasing confusion. Lactulose is causing frequent loose bowel movements so he is often OOB to commode.

Assessment
The daughter is exhausted and scared. She wants to keep him at home but panicked when she saw him on the floor.

Recommendation
x-ray or sutures if needed, otherwise, return home without admitting.

References
Institute for Healthcare Improvement. (2017). SBAR: Situation background assessment recommendation. Retrieved from http://www.ihi.org/resources/Pages/Tools/SBARToolkit.aspx

Patton, L. J., Tidwell, J. D., Falder-Saeed, K. L., Young, V. B., Lewis, B. D., & Binder, J. F. (2017). Ensure safe transfer of pediatric patients: A quality improvement project to standardize handoff communication. Journal of Pediatric Nursing, 34, 44-52. http://dx.doi.org/10.1016/j.pedn.2017.01.004