Improved communication after operations for greater patient safety
14.04.2016 09:42
Clear communication between the doctors and nurses involved is essential for successful teamwork in the operating room and intensive care unit. In order to improve cooperation within the medical staff, the German Society for Anesthesiology and Intensive Care Medicine e. V. (DGAI) issued current recommendations on structured patient handover after operations. The key point is the introduction of a communication tool in anesthesia and intensive care medicine, the SBAR concept, which aims to reduce communication-related errors.
The SBAR concept (S = Situation, B = Background, A = Assessment, R = Recommendation) was developed according to the DGAI evaluated in numerous studies in Europe, USA, Canada and Australia. “Structured patient handover contributes significantly to improving patient safety. “Especially in stressful situations, we have to communicate clearly with each other in anesthesia so that all important information is received,” says Professor Dr. Frank Wappler, Congress President of this year's German Anesthesia Congress (DAC) in Leipzig.
Accordingly, fixed rules of communication, so-called Standard Operating Procedures (SOP), have been established in the operating rooms. These standards also include a structured handover protocol such as the SBAR concept. Surgeons, anesthesiologists, assistants and nurses worked hand in hand before, during and after an operation.
Communication barriers influence patient handover
Certain barriers could impact effective patient handover. These included, for example, hierarchical structures or the fear of speaking freely to superiors or higher-ups, as well as limited time resources. In this case, standards in the handover are helpful so that everything runs smoothly even under great stress. The SBAR concept can improve communication and collaboration between the doctors and nurses involved and contribute to patient safety: Using the SBAR concept, several studies have shown a significant reduction in unexpected deaths and an improvement in patient safety.
What does the SBAR concept entail?
A brief guide to the four steps of the SBAR concept supports those involved in ensuring that all important information and recommendations are transmitted in a fixed, thematic order. The DGAI describes the concept: All information about name, age, gender, diagnosis, type of procedure and details about anesthesia are summarized under “Situation” (S). The “background” (B, background) includes, among other things, information about allergies, medications before the operation, comorbidities, preoperative diagnostics and events during the procedure. The “assessment” (A, assessment) contains, for example, information on storage, access, blood loss, blood and coagulation products, the current status of the operation, the latest laboratory values and medications such as antibiotics or painkillers. Finally, there is a “recommendation” (R, Recommendation) with operational details such as drainage, orders from the operating doctor, information on ventilation and postoperative pain therapy.