I-SBAR Ichazwe Ngezibonelo Zangempela

Yini i-SBAR?

Ngokuyisisekelo, i-SBAR iyindlela yokuxhumana eyakhelwe ukuhlinzeka ngokudluliselwa okunembayo nokucacile kolwazi olubalulekile. Isifinyezo simela:

• S - Isimo (Situation)
• B - Isizinda (Background)
• A - Ukuhlola (Assessment)
• R - Isiphakamiso (Recommendation)

Cabanga ngayo njengesitifiketi sokuxoxisana. Kuqinisekisa ukuthi lonke ulwazi olubalulekile luhanjiswa ngendlela enengqondo futhi elindelekile, kuqeda ukuqagela futhi kunciphisa amathuba okuthi imininingwane ebalulekile ingaqedwa.

Ngenkathi kuzwakala sengathi yenziwe yona ngezidingo zomhlaba wezokwelapha osheshayo, uhlaka lwe-SBAR lunomlando walo omangalisayo: i-U.S. Navy. Yaqala yathuthukiswa ukuze kuqinisekiswe ukuxhumana okungenamaphutha emikhunjini yama-submarine enesici, lapho umyalo owodwa ongachazwa kahle ungaba nemiphumela emibi kakhulu. Impi yayidinga indlela eyiyo yokudlulisa ulwazi oluphuthumayo phezulu esigabeni sobuholi, futhi i-SBAR yayiyimpendulo.

Ukuqonda amandla ayo, umuntu omusha kwezokwelapha uKaiser Permanente wenza ithuluzi le-SBAR ezindaweni zezokwelapha ekuqaleni kwawo-2000 ukuze kuthuthukiswe ukuxhumana okuhle kwezokuphepha kweziguli. Namuhla, liyasekelwa izinhlangano ezifana neWorld Health Organization futhi liyisisekelo sokuxhumana okusebenzayo kwe-nurse physician communication nokubambisana kwamaqembu emhlabeni jikelele.

Iziphawulo Ezine Zokwakhiwa Kwe-SBAR: Ukuhlelwa Okuningiliziwe

Umgilinga wemodeli yokuxhumana ye-SBAR usesimweni sayo esilula. Wonke amagama akukhuthaza ukuthi unikeze ingxenye ethile yendida, kudale isithombe esiphelele sezokwelapha kumlaleli. Ake sihlole uhlaka lwe-Isimo, Isizinda, Ukuhlola, Isiphakamiso ingxenye ngezingxenye.

S - Isimo: “Nansi inkinga esheshayo.”

Lena yihlayidi lakho. Isitatimende esifushane nesinesigwebo esisodwa esibamba ngokushesha ukunaka komlaleli futhi sibonise inkinga.

• Ubani wena nokuthi ukuphi: “NdinguSarah, udokotela obhalisiwe emnyangweni wezinhliziyo.”
• Ngubani isiguli: “…ngishayela mayelana noMnu John Doe egumbini 412.”
• Isizathu sokuthi uxhumane: “…ngikhathazekile ngokwehla okungazelelwe kwengcindezi yakhe yegazi nesiwula sakhe sobuhlungu obukhulu besifuba.”

Inhloso ukuhlela ingxoxo ngaphansi kwemizuzwana engu-15. Umuntu ohlangothini ngaleso sikhathi uyazi ngokushesha ukuthi ungubani, ukuthi yisiphi isiguli okhuluma ngaso, nokuthi kungani kubalulekile.

B - Isizinda: “Nansi imininingwane engozini.”

Manje njengoba usubabambe, hlinzeka ngolwazi olubaluleke kakhulu oluhlobene nesimo. Lokhu akuyona isikhathi somlando ogcwele wesiguli. Namathela ezindabeni ezibalulekile ezidingekayo ukuze kuqondwe inkinga.

• Ukutholwa kokungeniswa kanye nosuku: “UMnu Doe wangena ezinsukwini ezimbili ezedlule ngenxa ye-myocardial infarction.”
• Umlando wezokwelapha oyingozi: “Unomlando wokuba nomfutho wegazi ophakeme kanye nohlobo 2 lwesifo sikashukela.”
• Isifinyezo esifushane sokwelashwa kuze kube manje: “Wathola indawo yokubeka i-cardiac stent izolo. Isimo sakhe ngemuva kokuhlinzwa besibuthaka kuze kube manje.”
• Izimpawu zokuphila zakamuva kakhulu: “Ingcindezi yakhe yayingu-120/80 ihora elidlulile; manje isingu-85/50. Inhliziyo yakhe ishayelela ngamashushu angu-110.”
• Imithi engozini: “Uyaphatheka nge-heparin drip kanye ne-beta-blocker.”

A - Ukuhlola: “Nansi engicabanga ukuthi kuyenzeka.”

Lapha yilapho uhlanganyela khona isinqumo sakho esingochwepheshe sezokwelapha. Ngokwesimo nesizinda, yini ocabanga ukuthi yinkinga? Lesi sigaba sibalulekile ekubonise ukucubungula kwakho okunengqondo kwezokwelapha futhi kusiza ekudaleni isithombe esicacile.

• Bonisa isiphetho sakho: “Ngiyakholelwa ukuthi isiguli singase sibhekane ne-cardiogenic shock” noma “Ngikhathazekile ukuthi singase sibhekane nesiqalo esikhulu senhliziyo.”
• Noma, uma ungavamile ukucacisa, yisho lokho: “Angiqinisekile ukuthi yini inkinga, kodwa isimo sakhe sibonakala sibola ngokushesha.”
• Gqamisa izimpawu ezibalulekile: “Isikhumba sakhe sibanda futhi sinamathele, futhi ubukeka ekhathazekile.”

Ukuhlola kwakho kumnikeza udokotela noma uzakwabo indawo yokuqala ewusizo futhi kubonisa ukuthi uhlaziye idatha ngokubalulekile.

R - Isiphakamiso: “Nansi engidinga kuwena.”

Lena yiyona mbizo yesenzo. Yini oyidingayo ukuthi omunye umuntu ayenze? Yiba sobala, uqonde, futhi ucacise. Lokhu kungaba uvalo, ikakhulukazi kubahlengikazi abasha, kodwa mhlawumbe kuyisigaba esibaluleke kakhulu. Wena uyisikhulumeli sesiguli.

• Yenza isicelo esicacile: “Ngidinga ukuthi uze ubone isiguli ngokushesha.”
• Phakamisa indlela yesenzo: “Ngiphakamisa ukuthi sithole i-EKG esheshayo kanye ne-chest x ray.” noma “Ufuna ukuyala ukubandlululwa okufanele uqale ngakho?”
• Cacisa uhlelo: “Ngingalindela ukuthi ufike nini? Kufanele ngenze iminye imikhuba ngenkathi ngilindele?”

Isiphakamiso siqinisekisa ukuthi ingxoxo iphela nohlelo olucacile, ivale umzila futhi iqale isenzo.

I-SBAR Enze Izinto: Izibonelo Zezokwelapha Ezingokoqobo

Ukubona indlela yokuxhumana ye-SBAR isetshenziswa kuyindlela engcono kakhulu yokuqonda amandla ayo. Nansi iminye imibhangiso evamile.

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Isibonelo Se-SBAR 1: Umhlengikazi kuya Kudokotela (Isimo Esibalulekile)

Umdokotela uJessica ushayela uDkt. Evans ngesiguli esesimo saso sibi kakhulu.

(S) Isimo: “Dkt. Evans, nginguJessica, i-RN emnyangweni wokuhlinzwa. Ngishayela ngesakhiwo sakho, uNkk Smith egumbini 204. Ngikhathazekile ngobuhlungu bakhe obukhulayo nomkhuhlane ophansi.”

(B) Isizinda: “Ungumuntu wesifazane oneminyaka engu-65 ubudala, izinsuku ezimbili ngemuva kokuhlinzwa kwama-colectomy. Besebuyela kahle, kodwa emizuzwini emibili edlule, ubuhlungu bakhe bukhuphuke kusuka ku-4/10 kuya ku-8/10, futhi abuphenduli ku-morphine yakhe eyalelwe. Izinga lokushisa lakhe manje liyi-101.2 ° F (38.4 ° C), futhi isisu sakhe siqinile futhi sibuhlungu uma sichitha.”

(A) Ukuhlola: “Ngikhathazekile ukuthi angase abe ne-peritonitis noma ukuthi angaba nokuqhekeka kwe-anastomotic. Izimpawu zakhe zokuphila ziphendukela kolunye uhlangothi olungalungile.”

(R) Isiphakamiso: “Ngicabanga ukuthi udinga ukuza futhi umhlolile ngokushesha. Kufanele ngiyale i-CT scan esheshayo yesisu namalabhorethri okwamanje?”

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Isibonelo Se-SBAR 2: Umhlengikazi kuya Kumhlengikazi (Ukudluliselwa Kwezinguquko)

Umdokotela uTom unikeza umbiko wokudlulisa izinguquko kumhlengikazi uMaria.

(S) Isimo: “Sawubona Maria, ngidlulisela uMnu Davis egumbini 310. Uhleli kahle, kodwa siye saqapha isimo sakhe sokuphefumula.”

(B) Isizinda: “Ungumuntu oneminyaka engu-72 ubudala owangeniswa izolo nge-pneumonia yomphakathi. Unomlando we-COPD. Njengamanje usezintweni ezingama-2 ze-oxygen nge-nasal cannula, futhi izimpawu zakhe ze-O2 zihlala ziqinile ngo-94%. Umthamo wakhe wokugcina wama-antibiotics we-IV wawungo-4 PM.”

(A) Ukuhlola: “Amalahle akhe ayayizwa kancane kodwa ahlanzekile emanzini. Uphefumula kahle futhi ukhanyiswe futhi uqonde. Izimpawu zakhe zokuphila zihleli kahle. Sekukonke, ubonakala ephendula kahle ekwelashweni, kodwa i-COPD yakhe yenza abe nesiguli esiyingozi.”

(R) Isiphakamiso: “Ngiphakamisa ukuqhubeka nokuqapha izimpawu zakhe ze-O2 njalo ngamahora amabili. Umthamo wakhe olandelayo wama-antibiotics ungalindele ngo-10 PM. Sicela ubize umelaphi wokuphefumula uma umsebenzi wakhe wokuphefumula ukhula noma izimpawu zakhe zehlisa ngaphansi kuka-92%.”

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Izinzuzo Zokuhlanganisa i-SBAR Emkhubeni Wakho

Ukuthola uhlaka lwe-SBAR akuyona nje ukuphila isifinyezo esisha; kumayelana nokuqala ukuthuthukisa indlela esinakekela ngayo iziguli. Izinzuzo zicacile futhi zinjani:

• Kuthuthukisa ukuphepha kweziguli: Ngokujwayelekile ukudluliselwa kolwazi olubalulekile, i-SBAR inciphisa ubungozi wamaphutha ezokwelapha abangelwa ukuxhumana okungalungile. Kudala inethiwekhi yokuphepha ukuze kuqinisekiswe ukuthi imininingwane ebalulekile ayiqedwa.
• Kuthuthukisa ukucaca nokusebenza: I-SBAR iqeda ukudlulela futhi iye ngqo ephethini. Lokhu kubalulekile eziphuthumayo lapho sonke isikhathi sibalulekile. Kubhuloza isikhala sokuxhumana phakathi kwabahlengikazi, abavame ukucabanga ngendaba, nodokotela, abavame ukuncamela indlela eyimfushane.
• Kujwayele ukuxhumana: Noma ngabe ungumuntu omusha owazalwa noma ungumakadebona oneminyaka engu-30, ithuluzi le-SBAR lihlinzeka ngolimi oluvamile. Lokhu kuhlala phakathi kwezindlela kanye namazinga esipiliyoni kuqhuba isiko lokuxhumana okucacile nokulindelekile kwe-SBAR communication.
• Kuvumela abasebenzi bezokwelapha: Isigaba se-“Isiphakamiso” ku-SBAR nursing sivumela abahlengikazi ukuthi baveze imibono yabo yobuchwepheshe futhi bavikele iziguli zabo. Ibaguqula kusuka kubabikeli bedatha abangenzi lutho ukuya abahlanganyeli abasebenzayo kuhlelo lokunakekela.
• Kukhuthaza ukubambisana: Lapho wonke umuntu esebenzisa ifayela elifanayo lokuxhumana, kwakha ukwethenjwa futhi kwakha imodeli efanayo yengqondo. Lokhu kuyisisekelo sokuxhumana okusebenzayo kwe-nurse physician communication namaqembu ezempilo asebenzayo.

Amathiphu Okuba Nguchwepheshe KwiNqubo Ye-SBAR

Njengawo wonke amakhono, ukusebenzisa i-SBAR kahle kudinga umkhuba. Nansi iminye iminye iminye iminye amacebo okukusiza ukuthi uwazi:

1. Zilungiselele Ngaphambi Kokuba Ukhulumisane: Ngaphambi kokuba uthathe ucingo noma ungene egumbini, thatha imizuzwana engu-30 ukuhlela imicabango yakho. Yiba nohlelo lwesiguli, izimpawu zakamuva zokuphila, nemiphumela yamalabhorethri phambi kwakho. Qala amaphuzu akho e-S-B-A-R kunoti lwezikhathi uma kusiza.
2. Yiba Cofezile Kodwa Ugcwele: Inhloso ukuba mfushane, hhayi ukukhipha ulwazi olubalulekile. Gxila kulokho okubalulekile esigabeni samanje. Vimbela ukuba ungadukiswa yimiphumela kusukela ezinsukwini ezintathu ezedlule ngaphandle kokuthi zihlobene ngqo nenkinga yamanje.
3. Umkhuba, Umkhuba, Umkhuba: Dlala izimo ze-SBAR nabakwaziyo. Sebenzisa yona kwezintsha ezingekho ngokushesha ukuze uzizwe ukhululekile ngefomethi. Uma uyisebenzisa kakhulu, iyoba yingxenye yemvelo yesitayela sakho sokuxhumana.
4. Ungesabi Ukwenza Isiphakamiso: Lokhu kuvame ukuba yingxenye enzima kwabafundi nabahlengikazi abasha. Khumbula, isiphakamiso sakho singaba silula njengokuthi, “Ngidinga ukuthi uze ubone isiguli manje,” noma, “Ngicabanga ukuthi sidinga ukuthola umbono wesibili.” Usuzungezile, futhi ukuhlola kwakho kubalulekile.

Isiphetho

Endaweni eyinkimbinkimbi futhi evame ukuba neziphithiphithi kwezokwelapha, ukucaca kuyisipho—futhi futhi kuyisici esibalulekile sokuphepha kweziguli. Uhlaka lwe-SBAR ingaphezu nje kwe-acronym; kuyithuluzi elisindisa impilo elihlela izingxoxo, elinika amandla ochwepheshe bezokwelapha, futhi livikela iziguli.

Ngokuthatha imizuzwana embalwa ukuhlela imicabango yakho kuhlobo lwe-Isimo, Isizinda, Ukuhlola, Isiphakamiso, uqinisekisa ukuthi umlayezo wakho awuthunyelwa kuphela kodwa uyatholwa, uqondwe, futhi wenziwe into yawo.

Usukulungele ukukusebenzisa? Ngokulandelayo lapho udinga ukuxhumanisa isibuyekezo sesiguli, thola inothi elincane bese ubhala ngokushesha i-S, B, A, ne-R yakho. Uzomangala ukuthi ukwakheka okuncane kungaletha kangakanani ukucaca.