Effects of SBAR Utilization by Healthcare Providers on Patient Outcomes: A Systematic Review of the Literature

Abstract

Problem: Communication failures have been identified as a leading cause of sentinel events. Communication failures have been shown to lead to patient management errors which include falls risk, medication administration mis-management or error, and delay in patient treatment. Studies show that SBAR (Situation-Background-Assessment-Recommendation), a structured communication tool, helps guide communication among healthcare professionals and when used, can reduce the incidence of sentinel events and improve patient health outcomes.

Purpose: The purpose of this systematic review was to assess the literature evaluating the effectiveness of SBAR utilization by healthcare providers on patient health outcomes.

Search Strategy: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library Databases, PubMed, and non-indexed journals were searched for studies published from 2008 to 2019. Articles in English, with keywords SBAR, communication, patient/health outcomes, nurse, physician/doctor, interprofessional healthcare team or patient safety were eligible for inclusion. Studies conducted outside of inpatient settings or in simulated settings, and studies that did not measure patient outcomes were excluded.

Results of Literature Search: Out of 570 articles identified, eight articles met the inclusion criteria.

Synthesis of Evidence: Outcomes measured described in the articles include collaboration and perception of communication (n=7), incident reports related to poor communication (n=3), unplanned intensive care unit (ICU) admissions (n=1), decrease in unexpected deaths (n=1), and Foley removal compliance (n=1). Two overarching themes were noted: perception of collaboration and patient outcomes. There were significant improvements in perception of collaboration and communication, patient safety, number of incident reports, unexpected deaths, readmission rates, and Foley catheter removal compliance. Although one study noted a decrease in near-miss reporting and in the number of major falls, there was an overall increase in falls.

Implications for Practice: SBAR utilization among healthcare providers was found to have positive patient health outcomes as a result of clear, concise communication. Being at the forefront of patient care, registered nurses need to be educated in and encouraged to implement SBAR as a structured communication tool when speaking with healthcare professionals.