Using SBAR to Communicate With Policymakers

Carolyn Jurns, DNP, MSN, RN

Disclosures

Online J Issues Nurs. 2019;24(1) 

In This Article

Abstract and Introduction

Abstract

Nurses recognize and promote the importance of advocacy for nurses at all levels of practice. Despite increased involvement of nurses in policy arenas in recent years, existing evidence suggests a continued practice gap in nurse advocacy, particularly related to approaching national policy stakeholders. The reason for this gap are nurses' perceived lack of personal free time to engage in policy activities and perceived lack of skill in communicating with policymakers. The situation, background, assessment and recommendation (SBAR) situational briefing tool is an evidence-based communication tool familiar to many nurses. The purpose of this article is to discuss nurse advocacy and to examine SBAR as a means by which nurses can effectively and confidently interact with policymakers. The author discusses the history of SBAR communication, provides an exemplar of SBAR application in policy settings, and offers future research and educational implications. Using SBAR when engaging in activities with policy makers may help nurses overcome perceived barriers and more effectively engage with key policy stakeholders.

Introduction

Advocacy is an essential aspect of fundamental nursing practice and is an expected component of the nursing role (American Nurses Association ANA, n.d.). Multiple and varied healthcare organizations and nursing leaders urge nurse advocacy at all policy levels, ranging from bedside units to international healthcare venues (Kirpatrick, 2014; Patton, Zalon, & Ludwig, 2015; Porter-O'Grady & Malloch, 2016; Stokowski et al., 2010). The ANA (2015) Code of Ethics describes influencing social and healthcare policy as an ethical duty of all nurses; furthermore, the organization continuously promotes advocacy through example and resource offerings (ANA, n.d.). The American Academy of Nursing (2017) stresses the necessity of nurse advocacy to accomplish national healthcare goals. The Institute of Medicine of the National Academies appeals to nurses to be fully involved in, and sometimes lead, healthcare modeling and decision-making to optimize healthcare delivery and to advance the nursing profession (National Academies Press, 2011). The American Association of Colleges of Nursing (AACN) promotes advocacy (political and otherwise) as essential to professional nursing education, research, and practice (AACN, 2006; 2008; 2011).

"Advocacy is an essential aspect of fundamental nursing practice and is an expected component of the nursing role."

While it is well documented that nurses consistently advocate for patients in healthcare settings, they too often neglect advocacy in the policy arena (Disch, Keller, & Weber, 2015; Patton et al., 2015). Nurses have the potential to impact healthcare for several reasons. Nursing, identified by surveys as the most trusted profession (Brenan, 2017), the largest healthcare profession (Kreitzer & Koithan, 2014), and a profession which stands at the crossroads between healthcare policy and healthcare delivery, is potentially the most powerful profession to impact healthcare policy. Nurses' expertise, experience, knowledge and skills are essential to contributing to meaningful and relevant healthcare policy decisions. However, a substantial barrier to this influence is the lack of the profession's voice in the national healthcare policy arena (Robert Woods Johnson Foundation [RWJF], 2010). Two primary barriers to nurse advocacy include a perceived lack of personal free time and a perceived lack of skill when addressing policymakers (Cramer, 2002; Jansson et al., 2016; Jurns, 2017; Marshall et al., 2008; Vandenhouten, Malakar, Kubsch, Block, & Gallagher-Lepak, 2011). The SBAR communication tool can be an effective strategy for nurses to address these barriers and effectively interact with key policy stakeholders in a variety of policy venues.

"…nurses consistently advocate for patients in healthcare settings, [but] they too often neglect advocacy in the policy arena."

The purpose of this article is to discuss nurse advocacy and to examine SBAR as a means by which nurses can effectively and confidently interact with policymakers. I discuss the history of SBAR communication, provides an exemplar of SBAR application in policy settings, and offer future research and educational implications.

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