Level of Satisfaction of ISBARE Technique among Staff nurses in Intensive Care Unit: Descriptive Study

 

Thenmozhi P1*, Sabitha R2

1Professor, Medical Surgical Nursing Department, Saveetha College of Nursing,

Saveetha Institute of Medical and Technical Sciences, Chennai, India.

1M.Sc. Nursing II Year, Medical Surgical Nursing Department, Saveetha College of Nursing,

Saveetha Institute of Medical and Technical Sciences, Chennai, India.

*Corresponding Author E-mail: thenmozhi.sethu@gmail.com

 

ABSTRACT:

ISBARE is one of a number of frameworks for discussing patient issues among healthcare professionals. The ISBARE tool is utilized in nurse-to-nurse handoff processes as well as communication between nurses, doctors, and other healthcare professionals. Identify, Situation, Background, Assessment, and Recommendation is a communication framework that was implemented by the public health service in the 2000s.A descriptive study was conducted to assess the level of satisfaction of ISBARE technique on handover among staff nurses in Intensive Care Unit. A total of 60 samples who met the inclusion criteria were selected by purposive sampling technique. Assessment was done by using the 20 satisfaction questionnaire. Data were analyzed by using descriptive and inferential statistics. The study finding revealed that 34(56.7%) had satisfied and 26(43.3%) strongly satisfied in following ISBARE technique during handing over the patient and none of them had dissatisfied. Chi-square test showed statistically significant association between the level of satisfaction with selected demographic variables of information ISBARE handover time, age in years and type of ICU workingat p<0.05. The study finding concluded that nurses working in intensive care unit were satisfied with ISBARE technique during handing over the patient as it helps to report the comprehensive information about the patient thereby to provide good quality care.

 

KEYWORDS: ISBARE Technique, Handover, Staff nurses, Intensive Care Unit.

 

 


INTRODUCTION:

ISBARE is one of a number of frameworks for discussing patient issues among healthcare professionals. Utilizing the tool is thought to increase patient safety by fostering better organized, targeted, and succinct communication among medical professionals. Around 2003, the US healthcare system adopted ISBARE, and its main objective in patient safety work is to enhance communication1.

 

The World Health Organization endorsed, offers a standard method of communication that can be used in a variety of clinical contexts, including escalation of a deteriorating patient, shift changeover, patient transfer for a test or an appointment, and inter-hospital transfers2. The ISBARE tool is utilized in nurse-to-nurse handoff processes as well as communication between nurses, doctors, and other healthcare professionals. Identify, Situation, Background, Assessment, and Recommendation (ISBARE) is a communication framework that was implemented by the public health service in the 2000s. It is based on ISBARE, a method created by the US Navy to enable accurate, clear communications between nuclear submarines3. Patient discontent and reduced safety and quality of services have been linked to nurses' lack of communication during the handover process, which is responsible for 80% of significant health errors and 20% of patient issues. In intensive care units with highly fragile patients recorded, electronic reports and printouts, and unique forms, this is especially problematic. A structured communication tool would be helpful to efficiently transmit patient information, decrease adverse events, enhance patient safety, improve the standard of care, boost caregiver confidence, lower medical and technical errors, and prevent the loss of crucial information4. This technique enables nurses to accurately transfer medical data during shift changes and makes it simple to spot any data transfer errors. According to a compilation of evidence, training can boost performance in the workplace by 87% for organizations and 96% for individuals. Only a few researches have looked at nurses' handover practices in Hong Kong. This study sought to uncover factors influencing clinical handover quality, communication abilities, and nurse’s impressions of it specifically5. The audit involved three of us, and in both cycles we were the sole auditors. With both the day and night teams present, the handover procedure in the CT ICU entails a tour around the patients’ bedsides and a discussion of each patient in turn. Because of this, the only method to audit their handover was to tour the facility with them. Since knew whatwereauditing, there was a chance that behavior would change. However, this was a possibility for both cycles and was regrettably beyond the control6. This ISBARE technique is the promising technique for promoting good quality of care to intensive care patients and it is helpful for all the staff in intensive care unit to provides a good quality of care. Hence the present study was conducted to assess the level of satisfaction of ISBARE technique on hand over among staff nurses working in intensive care unit.

 

MATERIALS AND METHODS:

A descriptive study was conducted to assess the level of satisfaction of ISBARE technique on handover among staff nurses in ICU. The main study was conducted in ICU at Saveetha medical college and hospitals Chennai after obtaining formal permission from the hospital authority. A total of 60 samples who met the inclusion criteria were selected by purposive sampling technique. The investigator introduced herself and explained the purpose of the study to the participants. Informed written consent was obtained from participants and confidentiality was assured. The demographic variables were collected. Assessment was done by using the 20 satisfaction questionnaire. Data were analyzed by using descriptive and inferential statistics.

 

RESULTS:

Table 1 shows that in the age group majority of the staff nurses 24(40%) were 20 – 29 age in a year, 15(25%) staff nurses were 40 – 49 age in year, 13(21.7%) staff nurses were 30 – 39 age in year, 8(13.3%) staff nurses were 50 – 59 age in year. The majority of the staff nurses in gender wise were 45(75.0%) were in female and 15(25%) were in male gender. The majority of the staff nurses educational status 25(41.7%) were degree, 20(33.3%) were in masters degree, 15(25%) were in diploma. The majority of the years of experience 25(41.7%) were 5 – 9 years of experience, 20(33.3%) were <5 years of experience, 10(16.7%) were 10 – 14 years of experience, 5(8.3%) were ≥15 years of experience. The majority of the distribution of working unit 23(38.3%) were MICU, 16(26.6%) were CT-ICU, 14(23.3%) were SICU, 7(11.7%) was RICU. The majority of the working hours 37(61.7%) were working in 40-59 hours, 16(26.7%) were working in <40 hours, 7(11.7%) were working in 60-79 hours. The majority of working positions 36(60%) were in staff nurse and 24(40%) were in head nurse. Majority of the staff nurses have 41(68.3%) initial education. Majority of the staff nurses have 41(78.3%) using ISBARE at handing over time. Majority of the staff nurses 48(80%) were attended ISBARE training.

 

Table 1. Distribution of Demographic Variables among Staff Nurses in ICU’s

Demographic Variables

Frequency

Percentage

1. Age in years

a. 20 – 29

b. 30 – 39

c. 40 – 49

d. 50 – 59

 

24

13

15

8

 

40.0

21.7

25.0

13.3

2. Gender

a. Male

b. Female

 

15

45

 

25.0

75.0

3. Educational status

a. Diploma

b. Degree

c. Masters

 

15

25

20

 

25.0

41.7

33.3

4. Years of experience

a. <5 years

b. 5 – 9 years

c. 10 – 14 years

d.  ≥15 years

 

20

25

10

5

 

33.3

41.7

16.7

8.3

5. Working unit

a. SICU

b. MICU

c. RICU

d. CT-ICU

 

14

23

7

16

 

23.3

38.3

11.7

26.7

6. Working hrs/wks

a.<40 hrs

b. 40–59 hrs

c. 60 – 79 hrs

 

16

37

7

 

26.7

61.7

11.7

7. Working position

a. Staff nurse

b. Head nurse

 

36

24

 

60.0

40.0

8. Information ISBAR Initial Education

a. Yes

b. No

 

19

41

 

31.7

68.3

9. Information ISBAR handover time

a. Yes

b. No

 

47

13

 

78.3

21.7

10. Training about ISBAR

a. Yes

b. No

 

48

12

 

80.0

20.0

 

Table 2. Distribution of overall Level of Satisfaction among Staff Nurses in ICU’s

Level of Satisfaction

Frequency

Percentage

Strongly dissatisfied

0

0.0

Dissatisfied

0

0.0

Neutral

0

0.0

Satisfied

34

56.7

Strongly satisfied

26

43.3

Total

50

100.0

 

Table 2 shows that distribution of overall level of satisfaction among staff nurses in satisfied 34(56.7%) and in strongly satisfied 26(43.3%).

 

Table 3. Descriptive Statistics for Satisfaction amongStaff Nurses in ICU’s

Descriptive Statistics

Satisfaction score n = 60

Mean

70.47

Standard Deviation

3.17

Range:

Minimum score

Maximum score

 

65

81

 

Table 3 shows that descriptive statistics for satisfaction among staff nurses in ICUs the overall mean score is 70.47, the standard deviation is 3.17 and the range of minimum score is 65 and maximum score is 81


 

Table 4. Association between Level of Satisfaction and Demographic variables

Demographic variables

Level of Satisfaction

Chi-square test value and p value

Satisfied

Strongly satisfied

No.

%

No.

%

Age in years

a. 20 – 29

b. 30 – 39

c. 40 – 49

d. 50 – 59

 

16

6

6

6

 

66.7

46.2

40.0

75.0

 

8

7

9

2

 

33.3

53.8

60.0

25.0

χ 2 = 7.778

d.f = 3

p=0.050 *

S

Type of ICU

a. SICU

b. MICU

c. RICU

d. CT-ICU

 

5

18

4

7

 

35.7

78.3

57.1

43.8

 

9

5

3

9

 

64.3

21.7

42.9

56.3

χ 2 = 7.958

d.f = 3

p=0.047 *

S

Information ISBAR handover time

a. Yes

b. No

 

23

11

 

48.9

84.6

 

24

2

 

51.1

15.4

χ 2 = 2.773

d.f = 1

p=0.022 *

S

S – Significant

 


Table 6 shows that there is a significant association between level of satisfaction and selected demographic variables of age, type of ICU, information ISBAR hand over time at the level of p<0.05.

 

DISCUSSION:

Reporting during handover the patient is one of the moist important process in clinical nursing practiceto ensure continuity of care, patient safety, reduces communication errors and promotes job satisfaction among nurses. Rajinder Kaur et al conducted a study to assess the practices related to end of shift handover among staff nurses working and found that 33% had fair practices and 67% had good practice7. In another study by Kaushalya Patidar et al found that majority of nurses (56.7%) were having average scores on quality of hand over8. Nurses themselves are subject to stress which has an implication not only on the health and personal life but also on the job satisfaction and the quality of care rendered to the patients and stated that The job stress significantly influences the job satisfaction among the staff nurses by Suni.M et al9. A study by Abhishek Nair who revealed that on an average, 78% of the staff nurses had frequent stress and 22% had neutral stress10. Brain drain may also be the contributing factor to implement the quality care and MeenaKumariBimal et al concluded that 98% of staff nurses had more contributing factors whereas only 2% of staff nurses had less contributing factors intend to brain drain11. One of the techniques to reduce the stress and improves the job satisfaction is communication. Computer application and nursing informatics are important to complement and facilitate the use of its to support nursing practiceby preventing error and promoting continuity of care. It was found that 60% of staff nurses had inadequate knowledge on computer application12 and 64 % of the staff nurses had the average knowledge on the nursing informatics13. The clinical handover also entails the transfer of accountability and duty for patients' care, it is a crucial and high-risk communication event. The ability of nurses to transfer clinical care is inextricably influenced by their perspectives and communication skills. Only a few researches have looked at nurses' handover practices in Hong Kong. This study sought to uncover factors influencing clinical handover quality, communication abilities, and nurses impressions of it specifically Pun, J. (2021). The present study revealed that distribution of overall level of satisfaction among staff nurses in satisfied 34(56.7%) and in strongly satisfied 26(43.3%). The current study supported by Lim Swee Geok et al (2019) revealed that Overall, nurses were satisfied with the use of ISBARE and there was a significant association between gender and satisfaction of nurses towards usage of ISBARE. Although the nurses were satisfied with the use of ISBARE, there is a need to investigate the reason for lack of satisfaction with its efficiency of implementation14. The similar study supported by Yoon Goo Noh et al (2020) A nursing handover program using ISBARE improved nursing students' awareness of handover ISBARE, communication self‐efficacy and satisfaction with handover education after each step of instructional lectures. Although instructional lectures improved awareness of handover ISBARE, communication self‐efficacy and satisfaction with handover education only increased after scenario and nursing case‐based role‐playing15. The present study revealed that association between level of satisfaction and demographic variables among staff nurses in ICU were the association between the demographic variables of working unit is statistically significant p=0.047. Association between the level of satisfaction and demographic variables of information ISBARE handover time shows statistically significant p=0.022. Association between the level of satisfaction and the demographic variables of age in a year shows statistically significant p=0.050. The present study supported by Patricia Kitney et al  (2018) study found that education program over time produced statistically significant (p < 0.001) results for compliance with ISBAR principles for handover from anaesthetist to PICU nurse. The results of the audits from the other perioperative handover points provided baseline data that will be used for comparison with further audit data for these handover points16. Similar study supported by Sarah Dawson et al (2013) study found that the recording of vital signs and transfer of these data might be improved with better observation systems incorporating early warning strategies with the help of ISBARE technique. More effective teamwork could be achieved with further clinical communications training17.Hence, the Patient handover between nurses has been an important in the clinical nursing practice to exchange necessary patient information to ensure continuity of care and patient safety.

 

CONCLUSION:

This ISBARE technique is the promising technique for promoting good quality care to intensive care patients. It is helpful for all the staff in intensive care unit. ISBARE techniques provide a good quality of care. The ISBARE technique is the promising and future methods to reduce the handing over to easiest technique and time saving techniques used for emergency and critically ill patients among staff nurses in intensive care unit.

 

CONFLICT OF INTEREST:

Authors declare no conflict of Interest.

 

ACKNOWLEDGMENT:

Authors would like to appreciate and thank all the participants who actively participated in the study and extend their cooperation to compete the study successfully.

 

REFERENCES:

1.      Moi, E. B., Soderhamn, U., Marthinsen, G. N., and Flateland, S. The ISBAR tool leads to conscious, structured communication by healthcare personnel. Sykepleien Forskning. 2019; 14: 74699.

2.      Burgess, A., van Diggele, C., Roberts, C., and Mellis, C. Teaching clinical handover with ISBARE. BMC Medical Education. 2020; 20(2): 1-8.

3.      Munusamy, S., Suresh, R., Giribabu, K., Manigandan, R., Kumar, S. P., Muthamizh, S., and Narayanan, V. Synthesis and characterization of GaN/PEDOT–PPY nanocomposites and its photocatalytic activity and electrochemical detection of mebendazole. Arabian Journal of Chemistry. 2019; 12(8): 3565-3575.

4.      Pakcheshm, B., Bagheri, I., and Kalani, Z. The impact of using “ISBAR” standard checklist on nursing clinical handoff in coronary care units. Nursing Practice Today. 2020; 7(4): 266-274.

5.      Pun, J. Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context. BMC nursing. 2021; 20(1): 1-8.

6.      Ramasubbu, B., Stewart, E., and Spiritoso, R. Introduction of the identification, situation, background, assessment, recommendations tool to improve the quality of information transfer during medical handover in intensive care. Journal of the intensive care society. 2014; 18(1): 17-23.

7.      Rajinder Kaur, Rashmi Choudhary, Poonam Sharma. A Descriptive Study to assess the practices related to end of shift handover among staff nurses working in selected hospitals of district Mohali, Punjab with a view to develop handover giving sheets. Asian J. Nursing Edu. and Research. 2019; 9(1): 94-98.

8.      Kaushalya Patidar, S.N. Patidar. Exploration of Quality of Hand over Among Nurses. Asian J. Nursing Edu. and Research, 2014; 4(1): 117-118.

9.      Suni M S,  Nirmala V, Shani Sikkandar. Stress and Job Satisfaction among Staff Nurses. Asian J. Nursing Edu. and Research. 2017; 7(1): 31-34.

10.   Abhishek Nair. A study to assess the occupational stress among staff nurses at selected private hospitals in Raipur. International Journal of Nursing Education and Research. 2016; 4(2): 203-206.

11.   Meena Kumari Bimal, Ravneet Kaur, Ramandeep Kaur. Factors Intend to Brain Drain among Staff Nurses. International Journal of Advances in Nursing Management. 2016; 4(4): 327-330.

12.   Usha Rani R. A Study to assess the Knowledge regarding Information and Computer Application among staff Nurses in Selected Hospital, Bangalore. International Journal of Advances in Nursing Management. 2019; 7(4): 309-310.

13.   M Marie Rosy. Assess the Level of Knowledge and Attitude among staff Nurses on Nursing Informatics in KVM Super Specialty Hospital, Cherthala with a view to Develop a Self-Instructional Module. Asian Journal of Nursing Education and Research. 2018; 8(2): 215-219.

14.   Geok, l. S., yee, l. M., and lian, h. A. Level of critical thinking ability among nursing students. The Malaysian Journal of Nursing (MJN). 2019; 11(2): 31-39.

15.   Noh, Y. G., and Lee, I. Effects of a stepwise handovers isbarq programme among nursing college students. Nursing open. 2020; 7(5): 1551-1559.

16.   Kitney, P., Bramley, D., Tam, R., and Simons, K. Perioperative handover using ISBAR at two sites: A quality improvement project. Journal of Perioperative Nursing. 2018; 31(4): 17-25.

17.   Dawson, S., King, L., and Grantham, H. Improving the hospital clinical handover between paramedics and emergency department staff in the deteriorating patient. Emergency Medicine Australasia. 2013; 25(5): 393-405.

 

 

 

Received on 05.02.2023         Modified on 13.04.2023

Accepted on 22.06.2023       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2023; 11(3):135-138.

DOI: 10.52711/2454-2652.2023.00032