SBAR
What does the acronym SBAR mean?
Situation
Background
Assessment
Recommendation
What does the acronym STAR mean?
Stop
Think
Act
Review
Give at least 2 Red Rules?
2 Patient Identifiers
Time Out
2-provider Check
What does the acronym CUSS mean?
I am Concerned
I am Uncomfortable
This is a Safety issue
Speak Up / Stop the line
Who's responsible for patient safety?
EVERYONE!
When is it appropriate to use Safe in Action Tool, SBAR?
When escalating safety concerns or communicating critical information regarding any daily task.
How much of a pause is needed when utilizing the STOP in STAR?
It only takes 1-2 seconds to refocus your mind on the task on hand.
Name 2 patient identifiers
Name, first and last.
MRN
DOB
When is it appropriate to CUSS at work?
To express safety concerns appropriately.
What is one of the most effective ways to prevent the spread of germs and diseases?
Hand washing
You utilized an amazing SBAR while reporting a safety concern. You relayed your information and have received feedback. What should you do next?
Repeat the information back and use close loop communication. If applicable, do not forget to document any critical labs or important conversations in the chart.
When have you applied STAR in your daily work?
*open ended*
During a procedure time-out, you notice the leg marked is different than the leg mentioned. What should you do next?
Stop the line. Use CUSS or ARCC and escalate concern.
What is missing from this CUSS scenario?
I am concerned you gave the patient the wrong medication. I am uncomfortable because you did not double check the dosing before administration. This is a safety issue, that was an excessive dose. I need to speak up and notify the physician.
Nothing. This scenario utilized all the techniques CUSS has during a witnessed in-appropriate medication administration.
What do you do during an Active Shooter?
Run, Hide, Fight
What is missing from this SBAR?
My patient in room#321 says they have a headache. Can you order some meds?
Background and assessment are missing. Use SBAR to help guide your communication to create a more positive outcome.
S: Pt has a headache
B: None - what triggered the symptom?
A: None - Pain assessment: description and pain scale? any other symptoms?
R: Can you come assess and/or order meds?
After doing STAR, you noticed you did a mistake. What do you do next?
You can escalate safety concerns by using SBAR and CUSS. Promote "Just Culture!".
When do we usually do 2-provider check?
before blood administration
and/or
high risk medications
Hold up! You utilized CUSS perfectly and the safety concern was ignored. What other tool can you use to speak up and "Stop the line?"
You can utilize a majority of the tools like ARCC, STAR, and CUSS. You should always escalate any safety concerns if you feel they were dismissed. Promote "Just Culture!"
When is it appropriate to call a Rapid Response?
When you feel your patient is not stable.
When patient meets RTT criteria (mental status change, change in vital signs, sudden chest pain)
When you practice SBAR, what do you accomplish?
Complete and CLEAR communication.
You prevent back and forth questions and get what you need timely.
You paint the picture clearly to the person you are communicating to.
You utilized STAR after noticing a family member did not know the language you were speaking. What action should you take next?
Find an interpreter or locate the nearest language line device. Communication is key!
Why is Red Rule an absolute compliance?
To keep our patients AND employees safe!
Give me your best CUSS for this scenario:
A patient is leaking from their IV. You notice a big red mark surrounding the IV site and swelling on the extremity. The IV fluids are running continuously at a high rate.
I am concerned about the IV infiltrating
I am uncomfortable with how fast these fluids are running and the symptoms the patient is having.
This is a safety event.
Let me find the nurse or charge nurse for assistance.
Why are food not allowed in the nursing or hydration stations?
To prevent bugs!!!