Transcript Clinical Governance – Pursuing Quality, Safety and Excellence

Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
• Introduction
Who, what and where you are and why are you calling
also is this a good time to talk?
• Situation
What is happening now. “The situation is….”
• Background
What led to the situation. “By way of background…”
• Assessment
What you consider the problem is. “My assessment is”
or “I assess….”
• Recommendation
What should we do to correct the problem. “I
recommend…..”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Introduction
Who, what and where you are and why are you calling
Establish you are talking to the right person and that it
is convenient to have the conversation at that time (or,
where necessary, that the conversation must take place
now for a pressing reason)
• “Hi I’m Jane, a nurse on the medical ward at St
Elsewhere Hospital is this the Bed Manager? We are
currently looking after a gastro patient who requires
transfer to you, Can I discuss this patient with you now
please? ”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Situation
Give the situation as of now, including key information
such as patient’s age and gender, and current status
• “The situation is Mrs X is a 62 year old lady who
presented to us with a Gastro Intestinal hemorrhage
yesterday. Mrs X is under DR John who has advised
that she needs to be transferred to you today”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Background
Give the relevant background details such as presenting factors
and complications
“ By way of background Mrs X presented with melaena and
haemoglobin of 54, she’s had 3 units of blood in the last 20
hours, she has had 2 episodes of melaena, cark claret in colour
not fresh blood and is on a Somac infusion running at 10mls/hr
and IVF at 100 mls/hr, she has 2 x 18g IVCs and remains nil by
mouth. Observations are stable at the moment Heart rate 80
and blood pressure 113/56 and a-febrile, oxygen saturations
95% on 2L oxygen. Mrs X has a history of Pneumonia,
intermittent haemodialysis and acute myocardial infarction in
2007 for which she has been on Aspirin since her AMI”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Assessment
What do you consider is going on
• “On the basis of Mrs X’s observations we have
assessed that she is currently stable but is at
high risk of a possible rebleed”
Clinical Governance – Pursuing Quality, Safety and Excellence
ISBAR In Our Communication
Recommendation
Be clear about your recommendation or what you are asking of
the other person
• “It has been recommended that Mrs X be transferred to you
as she needs an endoscopy and further investigations,
ideally she would benefit from having a bed on the gastro
ward”