Conceptual Framework: The intervention for the implementation of SBAR tool was presented based on the Kurt Lewin’s Theory of Planned Change which emphasizes three core concepts; Unfreezing, Moving and Refreezing. These entails changing an old behavior, learning a new one and consolidating on the knowledge of the new behavior.
Research Question: Will the implementation of SBAR communication framework lead to improved understanding of peer-to-peer hand-off communication among final year nursing students in a tertiary Nursing school in Nigeria
Design/Methods: With the approval of the University Health Research Ethics Committee , this quantitative, quasi experimental study was conducted utilizing a pretest and post-test modality in a pilot study format. A convenient sample of fifty-seven final year student nurses, were recruited in a non-probability, purposeful sampling format according to their willingness to participate in the project having signed an informed consent. The setting was the nursing school auditorium, in the outskirts of Lagos, Nigeria. The participants’ baseline care team communication knowledge about hand-offs, was assessed in a ten-item pretest prior to intervention. The intervention was the implementation of the SBAR communication framework, through a Microsoft power point presentation and visual simulation designed to highlight the use of all components of SBAR tool in hand-off communication. The Participants took turns to role-play scripted scenarios using SBAR format prior to taking a post test. The evaluation of effectiveness of intervention, was done through a ten-item post-test of the same questions used in the pretest. Data was analyzed through descriptive statistics including means and standard deviations. A paired t test was used to determine the differences in the pretest and post-test scores. The Chi Square and Fisher Exact were also used as appropriate. However, content validity was established by faculty experts to whom the test instruments were presented for inputs and subsequent revision. Reliability testing was done post hoc on the post-test questions.
Results: A total of 57 participants completed the pretest and post-test. For statistical evaluation, a Fisher Exact and Chi Square values were determined. Paired t test was used, with the value of the post-test mean = 19.12; intermediate values include: t =14.08, df= 56 and p = .000 which was statistically significant.
Conclusion and Implication to practice: The visual simulation and role play program developed in this study provided the students with opportunity to learn the elements of a good peer-to-peer hand-off communication. It introduced successfully the elements of SBAR tool in a nursing institution that have not previously applied. A formal communication framework in hand-off communication was needed. The study which targets the senior year nursing students as they transition into practice would equip the students with knowledge necessary to make a change in communication, and care team collaboration in their respective areas of practice upon graduation. There was remarkable improvement in the post-test results when compared to the results of the pretest which suggests that the SBAR communication framework can be successfully implemented in the hospital setting and final year nursing class of other tertiary institutions in Nigeria and other less developed countries of the world.