Situation, Background, Assessment, and Recommendation (SBAR) May Benefit Individuals Who Frequent Emergency Departments: Adults With Sickle Cell Disease

• Published in: Journal of emergency nursing 2011-11, Vol.37 (6), p.559-561
• Main Authors: Jenerette, Coretta, Brewer, Cheryl
• Format: Article
• Language: English
• Subjects: Accident and emergency departments; Adult; Anemia, Sickle Cell - therapy; Assessment; Communication; Departments; Emergency medical care; Emergency Service, Hospital - organization & administration; Evidence based medicine; Health care; Health care industry; Helpseeking; Hospitals; Humans; Nursing; Pain management; Patient satisfaction; Sickle cell anaemia; Sickle cell anemia; Sickle cell disease; Trust
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2011.02.012

Sickle Cell Disease Sickle cell disease (SCD) refers to a family of inherited autosomal recessive genetic disorders that affects about 1 in 365 African Americans, with approximately 89,079 persons having the disease in the United States.5 The clinical manifestations of SCD often lead to unpredictable episodes of pain and feelings of inadequacy regarding patients' care.6 For these reasons, many adults with SCD avoid the health care system whenever possible and manage their pain at home.7 Using the iceberg analogy, Smith and Scherer7 note that most of the iceberg of SCD pain is submerged at home whereas only the tip of the iceberg is seen by health care providers. Individuals with SCD are concerned about the care that they receive in the emergency department, including time to treatment and staff attitudes and knowledge.16 These concerns are often validated by compromised opioid administration, delayed pain control, and premature decisions on disposition with early return visits and possibly avoidable hospital admissions.17 Credibility can be improved through communication skills, and therefore adults with SCD may be more likely to receive individualized, proactive pain strategies to improve the quality of their pain management experience in the emergency department.18 To increase the potential for appropriate and timely treatment, adults with SCD must be able to give the health care provider substantive information that leads the provider to arrive at the conclusion that this is a well-informed, credible individual.