The effect of situation, background, assessment, recommendation-based safety program on patient safety culture in intensive care unit nurses

Patient safety culture is an integral part of patient care standards and a prerequisite for safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; this communication model has gained popularity in health‑care settings, especially among professions such as nursing. However, there is little evidence that nursing professional education can enhance patient safety culture. The aim of this study was to investigate the effect of a SBAR‑based training program on patient safety culture in intensive care unit (ICU) nurses.

The quasi‑experimental study was carried out in 2018–2019 at areas covered by Shahrekord University of Medical Sciences, Iran. This study was performed on 60 nurses working in ICU. The participants were randomly assigned to two experimental and control groups of 30 each. For the experimental group, five workshop sessions of SBAR‑based program were held. For the control group, the patient delivery process was performed according to the ward routine. Data were collected using patient safety culture questionnaires before and 1 month after the intervention, and were analyzed using descriptive and analytical tests such as paired t‑test, independent t‑test, and Chi‑square test by SPSS 22.

The mean score of safety culture was 31 ± 23.5 and 55.2 ± 28.6 in frequency of reporting events, 32.8 ± 17.8 and 54.3 ± 19 in overall perception of patient safety, 23 ± 20.1 and 52.9 ± 26 in communication channel openness, and 35.2 ± 19.8 and 52.4 ± 18.8 in information exchange and conveyance before and after training intervention, respectively, so that they improved from poor level to neutral‑moderate level. There was no strength in any dimensions of safety culture; however, the implementation of the SBAR‑based program was significantly associated with patient safety culture (P < 0.001).

Improving patient safety culture requires attention to patient safety models such as SBAR approach that provides an appropriate and reliable structure for quality improvement. SBAR‑based program training is effective in promoting patient safety culture; therefore, it is recommended that managers use this technique to promote patient safety culture.