Promoting the SBAR Communication Tool with Nursing Students

Promoting the SBAR Communication Tool with Nursing Students

Konstantina Caris

New York City College of Technology/Nursing

NUR-1110/Caring for Clients with Common Alterations in Functional Needs

Activity Description: Provide a brief description of the activity

Knowing that patient handover is often poorly performed, with critical detail being omitted and irrelevant information included at patient handoff this activity stresses on implementing the use of the ISBAR tool with nursing students during clinicals. SBAR stands for situation (clearly and briefly describe the current patient’s situation), background (provide clear, relevant background information on the patient), assessment (state your professional conclusion, based on the situation and background), and recommendation (telling the person with whom you’re communicating what would you recommend correcting the problem).

This format ensures clinicians communicating significant information in continuity of patient care, preventing errors and harm in hospital settings or community settings. It provides a standardized approach to communication which is a core skill that needs to be taught to nursing students and junior clinicians. It highlights key elements and explores teaching techniques that aim to ensure the framework is rooted in practice effectively resulting in patient’s safety and better patient outcomes.

Learning Goals: What do you aim to achieve with this activity?

The goal of this activity is to develop the student’s critical thinking and communication skills during patient’s handover by following the SBAR format. The need to assess, understand, analyze, prioritize patient health issues, and recommend solutions, is imperative among clinicians in healthcare. Communicating accurate patient information from team to team is an essential component of good patient care, effective management of the patient’s condition, and teamwork. However, critical thinking skills does not happen overnight. Students need to practice this format constantly during clinical rotations to enhance critical thinking and communication skills and at the same time prevent patient errors.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This activity was implemented step by step during clinical rotations the entire semester. For two weeks we devoted 60 minutes learning and understanding the importance of the SBAR tool and how it works.

Next, for four clinical days students practiced the format taking into consideration the information they obtained while caring and assessing assigned patients. Their report emphasized on the patient’s main problem, on communicating appropriate patient’s history, the right examination/observation, and creating a clear recommendation.

At midsemester, while each student gave report, the other students listen and observed. At post conference they had the opportunity to critique the report by asking questions, make suggestions, and reflect if the sequence of the SBAR format was followed. For example: “If the student highlighted key elements of effective clinical information”, “Did they give excess information or too little”, “How did they feel being the presenter as opposed to observer”, or “What they would have done differently and why”. This activity took between 30-45 minutes.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This is an ongoing interactive high stakes assignment where the instructor assigned a patient to the student to assess and care the entire clinical day. During this time the student must think critically when deciding what patient information should be communicated to other healthcare professionals according to their assessment, knowledge, analysis, problem solving, and reflection. Practicing the ISBAR format during nursing clinicals increases their capacity to share key information, be mindful of their role as well as their team members, enhance their confidence on patient assessments, and implement optimal patient interventions.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

High stakes assignment=level of engagement.
Students who observed as well as the instructor had to complete a four-point scale ranging “Not performed the SBAR format competently”, to “Able to perform format under minimal direction”. Student’s performance focused on “What is going on with the patient”, “ What was the patient’s clinical background or context”, “If appropriate assessment/observation was done”, and “ What would they recommend to correct the problem”.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

A continuous effort to stress the importance to communicate key elements of effective clinical handover emphasized during clinicals with nursing students. By following the use of the SBAR format during clinical, prepares them not only for the clinical demands of the job, but also focuses on their critical thinking and communication skills that are so important for improving patient outcomes and recognizing a decline in a patient’s condition. At the same time instructors can explore teaching techniques that aim to ensure the framework is embedded in practice effectively.

Involving students to learn a structured way to communicate relevant patient information to other healthcare professionals was challenging due to overwhelming nursing material they had to cover during their semester. However, at the end of their clinicals they expressed that the SBAR format helped them organize patient information in a structured way saving time. Prioritizing on what information should they handover was also challenging because they had to focus on what is going on currently and taking into consideration patient’s general health status.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

SBAR

Situation-Background-Assessment-Recommendation

Example

Mr. Barnes is a 72 y/o admitted to the oncology unit yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He has a fever of 102.5 F. He’s receiving a continuous 48-hour infusion of Oxaliplatin and 5-FU. other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR16, O2 98%. He has no complaint of pain or discomfort, NKA. As the primary nurse you’re concerned about the fever and neutropenia. You would like and order for Tylenol, blood cultures, and a CBC.

Organized structured format for SBAR

Situation-Background-Assessment-Recommendation

S=This is Jane Doe, the primary nurse for Mr. Barnes, on the medical oncology unit. He is febrile, 102.5 F.

B- He was admitted yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He’s receiving a continuous 48 hors infusion of Oxaliplatin and 5-FU. He has no known allergies.

A-Other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR 16,02 98%. He has no complaint of pain or discomfort.

R- I am concerned about the fever and neutropenia, I recommend an order for Tylenol, blood cultures, and a CBC. Is there anything ales you would recommend at this time?

Please share a helpful link to a pages or post on the OpenLab

Critical thinking

Critical thinking

Wenhsing Yang

City Tech

NUR 2110

Activity Description: Provide a brief description of the activity

Critical thinking through writing assignments-understand the patient care with their needs

Learning Goals: What do you aim to achieve with this activity?

familiar with priority, delegation, quality of care

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

I used half hours in class and lab for students to think about patient care and how to intervene with their needs.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

students need to be familiar with the disease process and its influence to patients quality of life.
some are low-stakes, some are high-stakes, because it was being use in the simulation

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use Gen. rubric.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

i will repeat it but I will use different scenarios because every patients is different

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

Career Exploration Assignment

Career Exploration Assignment

Rosa Abreu

Hospitality Management/Professional Studies

Perspective in Hospitality Management

Activity Description: Provide a brief description of the activity

As students prepare for their internship and future career, they will research employment prospects within the Hospitality and Tourism industry. The students are to write a two page essay answering specific questions, write a cover letter and provide a one page bibliography.

Learning Goals: What do you aim to achieve with this activity?

Discuss the scope of the hospitality and tourism industry.

Evaluate and apply information discerningly from a variety of sources to classify and examine food and beverage operations.

Describe and discuss the roles and responsibilities of key executives and department heads in the hospitality industry.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment is introduced in week 6 of the semester, with a dedicated 45-minute session allocated for questions and answers.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This term project is high stake, as students are reintroduced to APA style guidelines and instructed on how to create a one page bibliography.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I utilized the AAC&U Information Literacy rubric for assessment purposes only. I don't use the rubric for grading students' work.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

This activity proved to be highly effective in my classroom. As part of the project, students delivered a three-minute presentation about their chosen career paths. This not only allowed them to showcase their own goals but also provided their classmates with valuable insights into various careers within the industry.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

Case studies -in class assignment

Case studies -in class assignment

Wenhsing Yang

Nursing

Medical-Surgical Nursing

Activity Description: Provide a brief description of the activity

You will be assigned to a group (4 to 5 students) and discuss this case study with a Google link. This activity will take 30 minutes. After that, you have 10 minutes to present your answer to the class. You will need to use textbooks and online resources to provide your answers and rationales. This presentation will take 10 minutes per group. Feedback is welcome.
The link is here https://docs.google.com/presentation/d/1ZXzJYcymsyznni6tVvNWhUbW8V1EsekWJWQhF9rdraM/edit?usp=sharing

Learning Goals: What do you aim to achieve with this activity?

The goals of this assignment are based on ACEN requirement (critical thinking) as follows:
The goal is to avoid having your decision cause injury to anyone
With critical thinking skills, you can weigh many factors and skillfully solve problems, making good decisions a majority of the time
Operating in a critical thinking model while pursuing nursing studies helps develop the clinical judgment needed to practice safe nursing
Nursing uses a knowledge base to make decisions, generate new ideas, and solve problems

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be used at the end of the cancer chapter (week five).
This activity will take 30 minutes. After that, you will present your answer to the class.
You have ten minutes to present your answers to the class.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I will need to create a scenario and questions for students to complete the assignment. You have 30 minutes to complete the assignment and present it to the class.
This is a group assignment; you will be assigned to a group to discuss your answer. Please note, you will need to provide evidence-based on your answer. Please feel free to use online resources and textbooks.
This is a low-stakes assignment because it does not cause danger to people. Instead, the students will have the opportunity to share the answers with the class and ask for feedback

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use the Value rubric -critical thinking. This is part of a college-wide general education assessment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, I will repeat this activity with different classes. Different case studies will be provided based on the course objective and outcome.
Only a few students discuss in the class, so I will need to facilitate the activity and ask other students for their input.
I will give each group different case studies, so the students will have different understanding of each disease and their nursing interventions.
Students like to hear from other groups with their answers and rationales. Because each group has different answers based on their priority and information. Additionally, students will be able to work with other students. In nursing, teamwork is necessary.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

Please share a helpful link to a pages or post on the OpenLab

Critical thinking

Critical thinking

Wenhsing Yang (Annie)

Nursing

Nur 2110

Activity Description: Provide a brief description of the activity

You will be assigned to a group (4 to 5 students) and discuss this case study. This activity will take 30 minutes. After that, you have ten minutes to present your answer to the class. You will need to use textbooks and online resources to provide your answers and rationales. Feedback is welcome.

Learning Goals: What do you aim to achieve with this activity?

The goal of this assignment is based on ACEN requirement (critical thinking) as follow:
1.Goal is to avoid having your decision cause injury to anyone
2.With critical thinking skills, you can weight many factors and skillfully solve problems, making good decisions a majority of the time
3.Operating in critical thinking model while pursuing nursing studies helps develop clinical judgement needed to practice safe nursing
4.Nursing use a knowledge base to make decision, generate new ideas, and solve problems.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be used at the end of the cancer chapter (week five).
This activity will take 30 minutes. After that, you will present your answer to the class.
This presentation will take 10 minutes per group.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I will need to create a scenario and questions for students to complete the assignment. You have 30 minutes to complete the assignment and present it to the class.
This is a group assignment; you will be assigned to a group to discuss your answer. Please note, you will need to provide evidence-based on your answer. Please feel free to use online resources and textbooks.
This is a low-stakes assignment because it does not cause danger to people. Instead, students have the opportunity to share the answers with the class and ask for feedback.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use the Value rubric -critical thinking. This is part of a college-wide general education assessment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, I will repeat this activity with different classes. Different case studies will be provided based on the course objective and outcome.
Only a few students discuss in the class, so I will need to facilitate the activity and ask other students for their input.
I will give each group different case studies, so the students will have different understanding of each disease and their nursing interventions.
Students like to hear from other groups with their answers and rationales. Because each group has different answers based on their priority and information. Additionally, students will be able to work with other students. In nursing, teamwork is necessary.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

Please share a helpful link to a pages or post on the OpenLab

Chef Report Self Assessment

Chef Report Self Assessment

Jessie Riley

HMGT

Culinary 1

Activity Description: Provide a brief description of the activity

In Culinary 1 each week students are assigned different positions in the kitchen and complete a chef report the week after they have served as chef. This was a disposable assignment. I created as self assessment rubric and discussed the assignment with students each week. We discussed evaluating ones own work to back and forward.

Learning Goals: What do you aim to achieve with this activity?

To provide the students a safe environment to evaluate their performance over the 15 weeks of the semester.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

It was described the first day and each week we would discuss the prior lesson and the up-coming lesson. In the class we devoted 15 minutes and outside of class it could take the students 20-40 minutes. to complete

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I started to use open lab but had some difficulty so moved the assignment to Blackboard. It is a low stakes activity

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I modified an assessment rubric and provided students with a hard copy and a soft copy

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, as this was the first time I believe it can be improved and I have discussed with the chair about having other instructors incorporate the assignment. The chef report is completed by students in 3 other courses so there is an opportunity to incorporate it into the student's portfolio

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

I will attach an excel work book and student assignments and the rubric in an email

Please share a helpful link to a pages or post on the OpenLab