Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie Hardin-Pierce

Clinical Mentor

Dr. Michael Kellihan

Committee Member

Dr. Elizabeth Burckardt


Background In 1999, the Institute of Medicine reported 98,000 deaths in US hospitals due to medical errors. The Joint Commission posits 70% of sentinel events are rooted in communication errors. The US military and aviation industry had developed structured communication tools to reduce communication error and shared this with healthcare in the form of the Situation Background Assessment Recommendation (SBAR) tool. The Joint Commission recommends use of the SBAR tool.

Objective Formal training on SBAR was not present at one acute care facility, constituting a gap between evidence and practice. This practice improvement project aimed to close this evidence-practice gap. The objective was to incorporate educating nurses on one floor of a 118 bed acute care medical facility in the Southeastern US. The goals were to achieve increased knowledge about SBAR and to achieve greater satisfaction with interprofessional communication.

Methods 27 nurses were educated on SBAR using didactic plus role-playing. Prior to the education, a multiple choice knowledge test (MCKT) was administered and a short version survey of communication satisfaction was administered (the ICUNPQ-SV, nurse version). After four weeks, the same MCKT and ICUNPQ-SV were administered to the nurses.

Results For the objective of educating nurses on SBAR, the first goal was to increase knowledge. Means from the posttest were higher than the pre-test, but not significantly p=.55. The second goal of increasing satisfaction was met, difference in means was p=.049 and individual item analyses of means demonstrated that overall job satisfaction increased significantly p=.024.

Conclusions The knowledge about SBAR did increase with these nurses, but not significantly. Many nurses are introduced to SBAR as part of their curriculum and the initial scores indicated familiarity with the tool. Satisfaction with communication increased, as did overall job satisfaction, but the reasons were likely multifactorial. Limitations of the study included sample size, homogeneity of subjects and inability to control such experiential factors as staffing or patient acuity at the times of the education or follow up. Direct causation from the education cannot, therefore, be concluded.

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