The Heart of the Matter: Bringing the R Back to SBAR

Abstract

This paper focuses on a quality improvement (QI) project implemented in a home health setting among a population of patients with heart failure (HF). It was discovered there was a lack of nurse-led recommendations and ineffective use of the situation, background, assessment, recommendations tool (SBAR) among home health nurse when communicating with providers about heart failure patients. Therefore, the QI project focused on creating and implementing a focused HF SBAR tool and a self-care patient check-list to be utilized by all home health nurses for all visits with heart failure patients. The focused HF tool was created and laminated and became part of home health nurse’s identification badges. The implementation phase took place over a 60-day time. Following implementation outcomes were measured and demonstrated an increased use of SBAR and an increase in nurse-led recommendations documented. Additionally, there was a decrease in acute hospitalizations for heart failure among home health patients. Furthermore, there was an increase in nurse-led interventions implemented in the home along with an increase of referrals to physical therapy (PT) and occupational therapy (OT). Finally, organizational leadership reported increased confidence and improved interprofessional communication among home health nurses and providers.