WHAT IS THE GOLD STANDARD IN SKILL EDUCATION?

Introducing ISBAR – a crucial communication skill for nurses & health care workers during patient handovers

Since the pandemic showed well-trained and skilled healthcare staff & nurses are relevant to the health system. This shortage of skilled staff is probably widely known, but the actual significance of the effects hardly goes beyond the professional circles. What the shortage of skilled and qualified personnel really means, what measures are now required, which role skill education plays for health care staff & nurses, and the relevance of skill education in India is explained on specific communication skill and explored in the following text.

International Nurses Day:

International Nurses Day (IND) is celebrated around the world every May 12^th, the anniversary of Florence
Nightingale’s birth. Before Florence Nightingale, there were no academic qualifications or training programs for the nursing profession. Florence Nightingale’s greatest achievement was to make nursing a respectable profession for women. Working in a military hospital during a war, she was able to prove by scientific methods that soldiers wounded in battle died mainly because of poor hygiene, sanitation and nutritional conditions. For this she was the first woman in London to be honored with a prize in the Royal statistical society. The training scheme laid down by Florence Nightingale not only served as the basis for the current model of nursing but gave “body and structure” to a discipline for which there was no script. In the absence of specific training nuns nursed the sick. But there were “unofficial” nurses who had little training and a bad reputation. To put an end to this “dark period” of nursing, she laid the foundation for the first nursing school in 1860. Through her commitment, Florence Nightingale stands like no other for the creation and development of nursing as we know it today.

(ICN, 2022)
Skilling India
India wants to “skill up” for the industry 4.0 To fulfil this dream, several initiatives have been proposed to boost the skilling sector. They are: Industry Connect: As industry linkage becomes important to provide demand-driven industry-relevant training opportunities, bridging the skill gap and facilitating demand-based skilled manpower to industries which would, in turn, add new jobs. Therefore the Government of India invites the national society and experts from all over the world to discuss this topic. Interests can be part of the discussion through “MyGOV” – Apps under the title «Reimagining Skill India 2.0: Inviting creative ideas and suggestions to help reinvent the landscape of skilling in India» till 30. June 2022.

What is Dual Education?

The often-cited “gold standard” label comes from a 2015 Harvard-backed study that deemed Switzerland top in an international comparative study of vocational education systems. Compulsory education lasts nine years in Switzerland. After that the path typically leads to a vocational apprenticeship. Apprentices learn in two, three or four years one of the 300 professions. Via both on-the-job practice and theory at a vocational college. Vocational education and training imparts the skills and knowledge needed to work in a given occupation. Vocational education and training forms the basis for life-long learning and serves as a gateway to numerous occupations. Vocational education and training is also open to adults. The Swiss Government and organisations all contribute to the high standard of vocational education and training and strive to ensure that there is an adequate number of apprenticeship positions available (swissinfo.ch).

(BSDU, 2022)

Dual Education in India

The Bhartiya Skill Development University (BSDU) in Jaipur is the first pure skills university in India. The BSDU follows the “Swiss dual education system” and has adapted the structures of theoretical & practical skill training to the local conditions and needs in India. BSDU applies modern teaching methods. Student’s acquire flexibly usable knowledge, develop interdisciplinary skills, and improve their problem-solving capability. At BSDU Health Care and Paramedic specialists learn in their work, not only take into account the state of health, the age, gender, biography and cultural, economic and social environment of the patients are also included. They establish a relationship of trust with the patients. This is central because Health Care and Paramedic specialists have a connecting function and act as intermediaries between further medical specialists and the patients as well as their relatives. They represent the interests of the patients and ensure an optimal exchange of information. They are responsible for the planning, execution, delegation and monitoring of the care measures. They carry professional responsibility throughout the care process.

(BSDU, 2022)

Why are skilled nurses and health care workers Important?

As we know that inappropriate skill knowledge could be dangerous to someone’s life, it is very important for us as healthcare workers to learn and focus on skills that may save a life. Organizations, including universities, nursing schools and hospitals, need to provide skill education and training for health professionals in order to prevent errors and provide quality care to patients in both hospital and home care settings. This applies to all sectors that provide health care services. Let’s make an example.

Real nursing & health care skills

What if you had been told an important piece of information that omitted important details and added irrelevant data being added to it – you would certainly be frustrated. Inaccurate communication or the loss of complex, important patient information during a clinical handover occurs fast and is dangerous for the patient. Therefore, all professional health care workers & nurses should get skill-based communication trainings during their studies where they learn how to apply the learned theory in the practical work field. As good communication prevents error and saves patients from serious consequences. Hereby providing high quality care to patients in hospitals and as well in home care settings. In a systematic review where Medication errors’ causes’ were analyzed in a home care setting. The findings showed that one of the main risk factors related to transitional care is poor interprofessional communication (Dionisi et. al. 2021).

Effective interpersonal and communication skills between health care providers and patients are one of the most significant factors for improving patients’ satisfaction, compliance and overall health outcome. That is, the sending and receiving of verbal and non-verbal messages between two or more people (de Vito 2013).

(McCabe and Timmins 2013)

How to apply ISBAR as a learned skill?

The ISBAR (Identify-Situation-Background-Assessment-Recommendation) technique is a simple way to plan and structure communication. It allows staff an easy and focused way to communicate and to ensure they get a timely and appropriate response.

(BSDU, 2022)

Imagine yourself as a nursing officer in a hospital, where you were called by a patient who is receiving a blood transfusion as he is unwell. Now you decide to call the doctor and transfer all the information in a structured way using ISBAR.

I	Good morning. This is Mili nursing officer from medical ward seven. Is this Dr. Lahoti speaking? I am calling about patient Mr. Shakeb Ali age 55 yrs. With registration number 12345.
S	I am calling because he is complaining of shortness of breath and his respiratory rate is 36 & his heart rate is 54 per minute. The blood pressure 90/60 mmHg.
B	The patient’s primary diagnosis is sickle cell anemia. He was admitted two days ago and he is currently on a blood transfusion.
A	I stopped the blood transfusion as I think the patient is having a blood transfusion reaction.
R	Can you please come just now to the patient and is there anything you would me to until the time you reach here?

Summary

India wants to “skill up” for the industry 4.0 to provide demand-driven industry-relevant training opportunities, bridging the skill gap and facilitating demand-based skilled manpower to industries. Well-skilled health care staff & nurses are relevant to the system. Before Florence Nightingale, there were no academic qualifications or training programs for the nursing profession. Inaccurate communication or the loss of complex, important patient information during a clinical handover occurs fast and is dangerous for the patient. Therefore, all professional health care workers & nurses should get skill-based communication training during their studies where they learn how to apply the learned theory in the practical work field. The ISBAR (Identify-Situation-Background-Assessment-Recommendation) technique is a simple way to plan and structure communication. BSDU in Jaipur follows the “Swiss dual education system” and applies modern teaching methods. Students acquire flexibly usable knowledge. Clinical skills like ISBAR, develop interdisciplinary skills, and improve their problem-solving capability.