Journal of Education and Health Promotion

Abstract BACKGROUND: 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.
MATERIALS AND METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.

Abstract BACKGROUND: Given new reforms in Iran’s health‑care system and due to the need for gathering
evidence regarding the implementation of this plan, this study aimed to investigate opportunities and
challenges created by resident specialist attendance plan guidelines in university hospitals.
MATERIALS AND METHODS: This study used the qualitative method. Semi‑structured interviews
were used for data gathering. The study population included all experts of Isfahan University of
Medical Science. Sampling was carried out using purposeful sampling method and continued until
data saturation was reached. In total, 16 experts were interviewed. Criteria such as “reliability of
information,” “trustworthiness,” and “verifiability of the information” were considered. Interviewees
were assured that their names would keep hidden and that all information is confidential. Subject
analysis method was used for data analysis.
RESULTS: The findings of this study based on subject analysis led to extracting three themes in
regards of challenges in the implementation of resident (specialist or fellowship) plan in hospitals
including structural, management, and resource challenges and one theme in the area of opportunities
which were improved quality and timely provision of services.
CONCLUSION: The findings showed that despite the strengths of this guideline, there are some
fundamental challenges in various areas and need better attention by national level policymakers.
These results help health‑care policymakers to evaluate the problem with a better attitude and
improve the necessary plans for implementation of these guidelines.