ISBAR Communication - Communication Is Key
ISBAR Communication - Communication Is Key
ISBAR Communication - Communication Is Key
Identify Identify yourself, who you are talking to and who you are talking about
Background What is the relevant background? This helps to set the scene to interpret the situation above accurately
Assessment What do you think the problem is? This requires the interpretation of the situation and background information to make an educated conclusion
about what is going on
Recommendation What do you need them to do? What do you recommend should be done to correct the current situation?
Identify
Situation
Background
Assessment
Recommendation
Name of nurse:
Name of nurse:
Date contacted:
Signature:
Pilot study
A pilot study on the use of the sticker was run on a 14-bed general
ward, which facilitates primarily surgical and medical patients.
This study was approved by the St Luke’s General Hospital National
Early Warning Score Project Group. Because patient data was
unnecessary, approval from an ethics committee was not required.
The aim of the pilot was to evaluate the perceived usefulness of the
sticker, utilising a self-efficacy questionnaire on communication.
This questionnaire was aimed at evaluating nursing staff ’s
perception of self-efficacy in communicating a deteriorating
patient’s condition in two domains:
Verbal notification of the deterioration to the appropriate
physician
Documentation of this communication in a clear and concise
manner.
Utilising a Likert scale with a score of one to five, where one
indicated ‘not at all’ and five indicated ‘extremely’, the staff was
asked to identify how confident they felt on their ability in these
two domains in relation to areas such as patient assessment
findings, concerns regarding the patient, requesting a review or
intervention.
All 14 nursing staff on the ward were asked to complete this
questionnaire prior to the introduction of the sticker. A total of
eight questionnaires were returned. The sticker was then made
available for use on the ward for a period of four weeks. Stickers
were readily available at convenient locations beside telephones in
an adhesive sticker format in order to facilitate ease of filing.
All nursing staff had attended prior COMPASS training and further
support on the use of ISBAR stickers was provided by two of the
COMPASS training faculty. The sticker was completed and filed in
the patients’ nursing notes when an increase in the patients EWS,
indicating a deterioration in the patients condition, prompted a
medical review. Following the four weeks, pilot nursing staff were
again asked to complete the same questionnaire. A total of eight
questionnaires were returned.
Results
Overall, there was an increase in scores from the pre- to the post-
pilot questionnaires. Scores of one and two indicating ‘none at all’
or ‘no’ confidence in their ability to communicate to a physician
that a patient is deteriorating and to document this event totalled
eight in the pre-questionnaire compared to none in the post.
Score of three indicating some degree of confidence increased by
one in the post questionnaire but score of four increased from total
of 50 to 57 and score of five remained the same at 95. See Table 3
for the total score results.
Total score results
Score 1 2 3 4 5
Pre-pilot 6 2 7 50 95
Post-pilot 0 0 8 57 95