Effectiveness of Nurse-led Educational Intervention on Therapeutic Communication of Undergraduate Nursing Students by Using SBAR tool

patient


I N T R O D U C T I O N
E cient communication is most noteworthy because it impacts patient quality care.A prepared tool might be helpful to adequately impart patient data, lessen unfavorable incidents, improve patient safety, enhance quality of care, and amplify the healthcare team members' satisfaction.Objective: To identify the effectiveness of nurse-led educational intervention on therapeutic communication of undergraduate nursing students by using the SBAR tool.Methods: This pre & post-quasi-experimental study was conducted from Jan-2021 to May-2021 among 120 undergraduate students from two different nursing institutions in Karachi by using a purposive sampling technique.Ethical approval was obtained and written informed consent was taken from each participant in the study.Data was collected by adopting the SBAR tool comprising 10 multiple-choice questions.Nurse-led educational intervention was provided after pre-assessment through lectures and discussion in the classroom.Data were analyzed using SPSS version-23.Results: Results showed a mean ± SD of age 30.44±5.40 varied from 23 to 51 years.Most of the participants (51.7%) were female and 70.8% of the participants had working experience ranging from 2 to 10 years.In the pre-test assessment, most of the participants secured a 4 out of 10 score (25.0%) whereas 8 out of 10 score (29.2%) in the posttest.A signi cant impact on the knowledge of undergraduate nursing students after educational intervention (p<0.001) was seen.Conclusions: This study concludes that undergraduate student nurses have very low knowledge related to the SBAR tool for therapeutic communication.Nurse-led education interventions improve nursing knowledge and understanding of the SBAR tool, as evident by post-test scores.The ndings of this study highlighted that nurse-led education intervention showed a signi cant improvement in the SBAR score on pre v/s post-assessment.These results were similar to the studies conducted in the Republic of Korea in 2017 [13], Iran (2023) [14], Korea in 2023 [15] and Norway in 2023 [16].However, these ndings were not supported by the study conducted in Indonesia in 2023 [17].In this study participants with age of 30-35 years were included.Similar age group were part of the studies conducted in Indonesia in 2023 and Egypt in 2023 [17,18].In contrast, a study conducted in Ireland in 2019, showed that most of the age group of the participants were with slightly higher age group [11].This study highlighted that more than ¾ of the study participants (86%) were having the clinical experience between 2-10 years.Participants with clinical experience ≤ 10 years did understand the tool in better way.These ndings are supported by a previous study (2015) conducted on Chinese nursing students with having less than 6 years clinical experience shows a signi cance improvement of the study participants' knowledge of SBAR and their self-perceived attitudes towards using SBAR tool [19].These ndings are contradicted to a previous study which was published in 2017 and was conducted in Qatar.

D I S C U S S I O N
This study was comprised on nurses with a range of 2-13 years of experience.However, this study did not show any signi cant association between SBAR score and the total experience of study participants [20].Findings of this study highlighted that majority of the participants were female.These ndings were similar to the studies conducted in Korea (2021), China (2021) and Korea in 2020, which showed the mostly highlighted participants were female [21][22][23].In addition, our study found no signi cant difference between gender and SBAR tool score.These ndings are opposed by a previous study which found a signi cant association between gender and satisfaction of nurses towards usage of SBAR tool [24].The results of this study showed that most of the study participants were enrolled in a two-year associate degree program.Whereas study conducted in Jordon in 2020, evident that most of the study par ticipants belonged to a four-year undergraduate program [21].Our study found a signi cant difference between program enrolled of the participants and SBAR test score (p=0.032).Although, there are studies which show the association between score improvement with SBAR intervention [13-17, 20, 22].However, no previous study found that showed the association between the SBAR scores speci cally with the programs enrolled of the participants.

C O N C L U S I O N S
This study concludes that undergraduate student nurses have a very low knowledge related to the SBAR tool for therapeutic communication.Nursing education i n te r ve n t i o n s , i m p r ove n u r s i n g k n ow l e d g e a n d understanding about SBAR tool, as evident by post-test scores.
Nursing and Midwifery, Dow University of Health Sciences (Ref No. DUHS/ION/MSN/2020/-18/412).Permission was taken from the Principals of both nursing institutions.Written informed consent was taken from each participant of the study.Two sets of data were collected between January to May 2021 by administering the pre-test and the post-test questionnaire.The validity and reliability of this tool, while used by Murray had scores that ranged between 10/50 and 50/50 (r=0.82)[12].All participants completed the pre-test in January 2021, followed by the intervention.The educational intervention was prepared using Microsoft PowerPoint which intended to discuss each component of the SBAR i.e.How the raw data of the patient can be transformed into intelligent, SMART, segregated information under S-B-A-R components for better understanding of all healthcare team members.This was supported by real-time scenarios and examples that nurses encounter daily during therapeutic communication.The total duration of the intervention was 2 hours (120 minutes).The participants were answered to their queries during interactive discussions with the research team.At the end of the session, the participants were given an SBAR presently prescribe this specialized tool to be utilized in a wide assortment of settings[9].Effective therapeutic communication by nurses is particularly important to ensure patient care.The World Health Organization reports that the density of nurses (per 10,000 population) in urban and rural areas of Pakistan is 7.6%[10].In such circumstances the chances of communication errors do increase and may also compromise the patient's safety.Standardized communication may ensure the safe transfer of patient information with minimal margin of error.The training to use such tools of communication is especially important as it will aid in uniformity and completion of patient's essential data properly and with least effort.Hence, the objectives of this study were to assess the knowledge level of communication skills among undergraduate nursing students and to determine the effects of SBAR communication tool as an educational inter vention in undergraduate Nursing students' therapeutic communication.version11 with a 95% con dence Interval, 80% power of test, 5% margin of error, and a mean score of 94% of postassessment of study participants[11], the calculated sample size was 120 participants.Approval was obtained from the Institutional Review Committee of the Institute of take-away card with a summary of each component to assist as a road map to employ the tool.The post-test was done in May 2021.Data were analyzed by using SPSS version 23.0.Paired sample-t test and Pearson correlation analysis were used for pre and post-test score comparison was used.Moreover, a p-value<0.05was considered signi cant.

Table 1 :
Socio-Demographic Characteristics of Participants Table 2 reveals the Mean test scores of the pre and posttest results.Pre-test score Mean ± SD 4.18±1.88and for the post-test score Mean ± SD 7.51±1.57.It is evident that most undergraduate nursing students do not have adequate knowledge regarding the usage and the various components of the SBAR tool.However, the participants demonstrated improved knowledge about the general usage after the post-test scores were analyzed.Hence, the scores improved after the educational intervention showing signi cant impact (p-value= <0.001) in the comparison analysis between pre-test and post-test.

Table 2 :
Comparison Analysis between Pre-test and Post-test