The experiences of registered nurses and specialist ICU nurses before and after implementation of ISBAR – a survey

Abstract

Background: Communication failure is one of the main causes of adverse events in the health service. In particular, the transfer of patient responsibility can represent a risk if important information is not passed on. The World Health Organisation and the Norwegian Health Directorate recommend using the communication tool ISBAR (identi cation, situation, background, assessment, recommendation) to ensure safe verbal communication during patient handovers.Objective: To survey the experiences of registered nurses in ICU and on general hospital wards with verbal transfer reporting, before and after implementation of ISBAR. Method:We conducted a survey in an intensive care unit and on three medical wards in an e ort to chart the registered nurses' experiences of transfer reports, before and after ISBAR was implemented. The data analysis was based on descriptive statistics and non-parametric testing. Answers to open-ended questions in the questionnaire were subjected to content analysis.Results: A total of 89 registered nurses responded to the survey at the pretest stage (64 per cent) and 87 at the posttest stage (56 per cent). Compared to the pretest, the posttest showed greater standardisation of transfer reports (p = 0.001) and greater time-e ciency (p = 0.001) after the introduction of ISBAR. In the posttest, 83 registered nurses (95 per cent) agreed that ISBAR had improved patient treatment, and they felt more con dent when taking over responsibility for patients (p = 0.003). Conclusion:ISBAR is a time-e cient communication tool that can help to improve the treatment of patients, produce more structured transfer reports and standardise patient handover information. Introducing changes to clinical practice can be challenging, but training and the introduction of a range of di erent information material proved to be e ective measures when introducing ISBAR to the hospital.Communication failure between healthcare personnel is the cause of more than 60 per cent of adverse events in hospitals (1). Patient handovers are particularly prone to communication failure (1, 2), and the latest annual report issued by the Government's Incident Reporting System referred to 317 adverse events that had occurred during patient transfers in Norwegian hospitals (3).