GUIDELINE TOOLS PROTOCOLS in Reporting related to Client Care

By: Glyze Bunda

 IDENTIFY, SITUATION, BACKGROUND, ASSESSMENT, RECOMMENDATION,
READ BACK/REPEAT
ISBAR/ ISBARR is an acronym for Situation, Background, Assessment, Recommendation, Read
Back; a technique that can be used to facilitate prompt and appropriate communication. This
communication model has gained popularity in healthcare settings, especially amongst
professions such as physicians and nursing.
A standardized communication tool developed by Lenard, Graham, & Bonacum (2004), as SBAR,
that was modified by Jansky & Zafi to ISBARR, Introduction, Situation, Background, Assessment,
Recommendation, and Read Back/Repeat.
The ISBARR (Identify, Situation, Background, Assessment, Recommendation, Read back/Repeat)
communication tool is a successful and widely used communication tool within the healthcare
setting (Kostiuk, 2015). In addition to providing a framework for preparation, this
communication tool ensures important details are not missed and minimizes the risk of
communication error (Kostiuk, 2015). The ISBARR communication tool has recently been
validated again in Australia as an effective way to improve the clarity and content of clinically
based communication.

ELEMENTS OF ISBARR
• I – Introduction Who you are, your
role, where you are and why you are
communicating S – Situation What is
happening at the moment?
• B – Background What are the issues
that led up to this situation?
• A – Assessment What do you believe
the problem is?
• R – Recommendation What should be
done to correct this situation.
 CHANGE OF SHIFT REPORT
 The handoff communication or change-of-shift report is given to all nurses on the next shift. It is
defined as the process in which information about the patient/client/resident care is
communicated in a consistent manner including an opportunity to ask and respond to
questions.
 Hill and Nyce (2010) identified three important features in an effective change-of-shift-report.
These are:
 “Two way”
 “Face to face communication; written support tools; and content in handover which captures
intention”
 Change of shift reports may be written or given orally, either in a face-to-face exchange or by
audiotape recording. The face-to-face report at the client’s bedside permits the nurse to
introduce the oncoming nurse to the client and family. The oncoming nurse has the ability to ask
questions during the report and address concerns.
 Written and tape-recorded reports are often briefer and less time consuming.
 A variety of handoff communication tools have been developed to facilitate consistency in
communication. Examples include, But are not limited to, the “I PASS the BATON”, “I-SBAR”,
“PACE”, or the “FIVE- Ps” each tool is unique and specific to the needs of the environment.

Key elements for effective handoff communication

 Up to date information
 Interactive communication allowing for questions between the giver and
receiver of client information.
 Method for verifying the information
 Minimal interruptions
 Opportunity for receiver of information to review relevant client date.

SAMPLE HANDOFF COMMUNICATION

• IPASS the BATON: Introduction, Patient, Assessment, Situation, Safety Concerns,
Background, Actions, Timing, Ownership, Next
• ISBAR: Introduction, Situation, Background, Assessment, Recommendation
• PACE: Patient/Problem, Assessment/Actions, Continuing(treatments), Changes,
Evolution
• Five Ps: Patient, Plan, Purpose, Problem, Precautions, Physician (assigned to coordinate)