I recently re-listened to a discussion with nurse leaders working in the Idaho State Prison system on the Correctional Nursing Today podcast  and I began to think about issues with clinical communication in our specialty. Correctional nurses, of course, are not the only nurses challenged to communicate effectively with providers to ensure safe and effective care delivery, but we must always consider the rather unique environment in which we practice.  

The Idaho nurse leaders discussed two key components of their communication system that made a big difference in the quality of interdisciplinary communication and improved the effectiveness of the care they delivered behind bars, saving both time and money in the process.

The SBAR Communication Model

Communicating important information during a critical incident can be difficult. SBAR is an organizing framework for concise verbal communication advocated by many patient safety organizations and accrediting bodies. The SBAR format helps nurses share important information so that decisions can be made about emergency care. The system works well in any clinical communication or patient hand off. Each letter stands for an information set: S-Situation; B-Background; A-Assessment; R-Recommendation. There are many tools available to teach and use the SBAR communication format.

The second element that improved communication in the Idaho Prison system was the use of a standardized documentation form with checkboxes and prompts. Checklists have been found to increase patient safety in many areas of healthcare (surgery, childbirth, flu, ICU) , why not team communication in corrections? Written event documentation assists in the original communication, reduces legal risk should a case come under review and provides a mechanism for quality review and process improvement activities. They can also be used as scenarios in staff training.

A structured model of information delivery and a documentation system that prompts for the right information allows nurses in the Idaho system to quickly convey needed information to providers on-call and off-site during a patient event. Are you using communication tools in your correctional nursing practice? Share your experiences in the comments section of this post.