Introduction
Since a nursing organization is likely to interact not only among nurses but also with various occupations including doctors in a hospital, communication skills of nurses are essential to handle practical tasks. Effective communication skills help in finding solutions to patients’ problems and enhance students’ self-confidence of taking care of patients [1]. Ineffective ways of communication negatively affect mortality rates, abnormal cases, near miss cases, and financial loss in healthcare fields as well as complaints among patients [2]. In addition, communication problems impair relations among doctors and nurses and cause frustrations and stress as well [3].
According to the Joint Commission on Accreditation of Healthcare Organizations [4], handover problems were one of the major causes of incidents that involved harm from 1995 to 2006, and among these, critical cases resulted mainly from a communication problem. Handovers are essential for patient safety since they are to maintain the continuity of nursing by delivering accurate information on patient conditions, nursing records, and recent changes [5-6]. According to one domestic research by Kim, et al., [7], 5.7% of the participant nurses were sure that they implemented the handover process appropriately and 12.1% were sure that they took over the duties properly, which indicates that even clinical nurses doubted the precision of handovers. Besides, most nurses expressed dissatisfaction with handovers [8], regarding time of handovers, unnecessary or inaccurate contents, lack of confidence, lack of standardized tools, and so
International Journal of Bio-Science and Bio-Technology
Vol.7, No.6 (2015)
190 Copyright ⓒ 2015 SERSC
forth [6-7]. Since the importance of patient safety was recently emphasized in Korea, attention has been paid to handovers as well.
Still, research is limited to the actual condition of handovers [7] and application of recordings to handovers for improvement [9], and the necessity to develop a standardized guideline for handovers is emphasized to enhance the efficiency of nursing tasks and maintain patients’ safety [6].
According to Collins [10], nurses who have graduated are required to develop capabilities to notify doctors of an emergency situation of patients, which requires assessment on importance of matters, skills of clear reporting, managing and predicting the order of emergency situations. These factors, however, have hardly been included in educational intervention for communication skill improvement among nurses.
Student nurses may not fully understand what a good handover is in terms of structure and content, when and to whom a handover needs to be provided, etc. They may feel not fully capable of handovers for such reasons as lack of practicing opportunities, etc. Besides, in observation of undesirable handover practices, they recognize the risk of the insufficiency of acceptable standards and have little self-confidence and discernment in personally practicing handover skills [10]. Even if a curriculum may provide nursing students with opportunities of communication and report experiences, students feel difficult to put such skills into practice clinically due to their worry about patients’ safety. In addition, nursing students are not certain about where to learn and develop such skills, where to practice such skills with safety secured, and how to acquire and develop skills to transfer knowledge related to handovers in practical tasks. In reality, therefore, it is challenging for students to develop capabilities to handle information of handovers.
The approach of SBAR (Situation, Background, Assessment, and Recommendation) for handovers helps in structuralizing given information [11] and improving knowledge and self-confidence among students practicing handovers in safe circumstances [5]. Recently, it was reported by a domestic research that after an education program of SBAR was conducted among nurses, their communication clarity, the medical staff’s satisfaction, information organizing skills, and patients’ safety were all improved [12]. In particular, communication clarity, which is required to emphasize imminent problems and present them in a logical order, turned out to be improved most significantly after the application of the SBAR program. However, there are few domestic hospitals that adopt SBAR tools in handovers, and there are few researches on this matter either. It is necessary to verify if SBAR is substantially effective and to provide nursing students with opportunities to learn and demonstrate handover methods and contents in a specific and standardized way.
Accordingly, this study aims to grasp the current condition of handover communication that nursing students actually experience in clinical practice, analyze handover contents by means of SBAR, and thus provide the basis for the development of handover communication strategies