Application Effects of SBAR Communication Mode in ICU Nursing Physical Restraint Shift.

Context: Correct and effective handovers of patients' information during shift changes can ensure patients' safety and can help an incoming shift of nurses to continuously monitor patients' psychological problems and avoid unnecessary physical restraints. Development of a standard procedure for handover of patients who have been physically restrained has important clinical significance related to the smooth continuation of nursing work and assurance of the quality of care.

Objective: The study intended to investigate the clinical effects of the situation-background-assessment-recommendation (SBAR) communication mode on the quality of the information passed during shift changes about patients in intensive care units (ICUs) who had been physically restrained and to compare it to the clinical effects obtained using traditional methods of communication.

Design: The study was a retrospective analysis of the process used by nurses who were passing patient's information during shift changes when caring for patients who had been physically restrained.

Setting: The study took place in an ICU at the Second Hospital of Hebei Medical University in Shijiazhuang, Hebei, China.

Participants: Participants were 21 nurses caring for 239 ICU patients under physical restraint at the Second Hospital.

Intervention: Of the 239 patients, 118 had been hospitalized between March 1 and March 15, 2018 and were assigned to the control group, and 121 had been hospitalized between June 1 and June 15, 2018 and were assigned to the intervention group. An ICU Physical Restraint Handover Order was established according to the SBAR communication mode. The intervention group used the SBAR communication mode and the control group used the hospital's routine communication mode for the physical restraint of a patient during a nursing shift.

Outcome Measures: The study measured the differences between the groups in the nurses' passing rates based on standards for the use of physical restraints, the quality of handover of information during shift changes about patients under physical restraint, the quality of the documentation written by nurses about the physical restraint, and the nurses' satisfaction with the handover of information during a shift change.

Results: Among the patient, 112 in the intervention group (92.56%) and 92 in the control group (77.97%) were qualified for physical restraint. A statistically significant difference existed between the two groups in the passing rate for the use of physical restraints (P = .001). The quality score for the handovers during shift changes of patients under physical restraint in the intervention group was 95.46 ± 2.50 and for the control group was 91.08 ± 3.57, with the difference being statistically significant (P = .030). The quality score for the nursing documentation for the intervention group, at 97.21 ± 1.49, was higher than that of the control group, at 90.78 ± 3.42, and the difference was statistically significant (P < .001). The nurses' satisfaction score for the intervention group, at 98.14 ± 1.01 was higher than that of the control group, at 92.57 ± 1.86, and the difference was statistically significant (P = .006).

Conclusions: The use of the SBAR communication mode to improve the information passed to nurses about patients under physical restraint during a shift change can improve the quality of the physical restraint and nurses' satisfaction and has a better clinical-application effect than the traditional methods used during shift changes.