SBAR - A Communication Technique for Today's Healthcare Professional

Situation, Background Assessment, Recommendation

SBAR is a standardized way of communicating with other healthcare givers. It promotes
patient safety because it helps physicians and nurses communicate with each other. Staff
and physicians can use SBAR to share what information is important about a patient. It
improves efficiency because this standardized form of communication helps caregivers
speak about patients in a concise and complete way. SBAR is an acronym that stands for:
Situation

Background
Assessment
Recommendation

Standardize Communication among Staff and Caregivers

SBAR offers hospitals and care facilities a solution to bridge the gap in hand-off
communication through a standardized approach to patient reporting at shift changes and
during patient transfers.
Using SBAR, patient reports are more accurate, efficient, and consistent enterprise-wide.
This simple, yet highly effective communication technique can be used when:
A nurse is calling a physician
Nurses are handing off patients to one another

Nurses are transferring patients to other facilities or to other levels of care

Why is SBAR recommended for calls to physicians?

SBAR promotes better communication. In most cases nurses and physicians
communicate in very different ways. Nurses are taught to report in narrative form,
providing all details known about the patient. Physicians are taught to communicate in
using brief bullet points that provide key information to the listener.
Here is an example of a call to a physician using SBAR:
Dr. Jones, this is Deb McDonald RN, I am calling from ABC Hospital about
your patient Jane Smith.
Situation: Here's the situation: Mrs. Smith is having increasing dyspnea and is
complaining of chest pain.
Background: The supporting background information is that she had a total knee
replacement two days ago. About two hours ago she began complaining of chest pain.
Her pulse is 120 and her blood pressure is 128/54. She is restless and short of breath.
Assessment: My assessment of the situation is that she may be having a cardiac event
or a pulmonary embolism.
Recommendation: I recommend that you see her immediately and that we start her on 02
stat.

Why implement SBAR in your organization?

The safe and effective care of patients depends on consistent, flawless communication
between caregivers. Hand-offs or the process of passing on specific information about
patients from one caregiver team to another, is an area where the breakdown of
communication between caregivers often leads to episodes of avoidable harm to a patient.
The Joint Commission on Accreditation of Hospitals has added to Goal 2 in the 2007 Patient Safety Goals. The additional statement
(2e) reads, Implement a standardized approach to hand off communications, including an opportunity to ask and respond to
questions.

SBAR Tool for Calling a Physician

BEFORE Calling the physician:
Assess the patient.
Review the chart for the appropriate physician to call.
Have chart in hand. Read the most recent physician and nursing notes.
Have all lab results available either in print or be logged into Meditech
Every SBAR report is different. Focus on the problem. Be concise.
Not everything in the outline below needs to be reported just what is needed for
the situation. Check all that apply.

___Code Status: ___________ ___ Allergies:_____________

___ IV Fluids: ______________

Situation
Your Name __________
Patient Name
I am concerned about

Background
The patient is in the hospital because ________________________________
Significant Vital Signs are _________
Significant Labs:___________________________________________________
Significant Test Results:_____________________________________________
The patient if complaining of_________________________________________
The patients physical assessment demonstrates ________________________
_________________________________________________________________
This is a change from _______________________________________________
The following interventions have been tried: ___________________________
_________________________________________________________________

Assessment
My assessment of the situation is _____________________________________
_________________________________________________________________
might be happening.
Tell the physician if the problem is severe and may be life threatening.

Recommendation/Request
I think the following needs to be done:
Medication ___________________________
Tests ___________________________
Physician needs to come now and assess the patient.
___________________________
Transfer to ICU ___________________________
Do you want me to call you back for any reasons?
______________________________________________________
What would you like me to do if the patient does not improve?
___________________________

Unit
Room #

Shift Report Using SBAR Format

Situation:
Patient Name
.Room Number
.Admission Date
.Physician(s)
Background:
Admission Diagnosis (date of surgery)
Past medical history that is significant (hypertension, CHF, etc) .
Allergies
Code Status (any advance directives, DNR orders,) .
Procedures done in previous 24 hours including results/outcomes (include where
we stand with post procedure vitals/assessment)
Assessment:
Biophysical assessment (abnormals) .
Abnormal vital signs .
Dressing condition (changes)
NG/Drain output
IV fluids/drips/site; when is site to be changed .
Current pain score-what has been done to manage pain .
Rhythm (if on telemetry)
Recommendations:
Do we need a change in the plan of care? .
What are you concerned about?
What are you uncomfortable with? .
Discharge planning .
Pending labs/x-rays, etc
We need to request a change in _________ (diet, activity, medications) .
We need to request a consult with PT/ST/OT, dietician, diabetes nurse, social
worker, wound care nurse, etc)
We need to contact Dr. __________about___________