This review will cover the SBAR communication acronym that is used in nursing for various forms of communication.
Review objectives are the following:
- What is the SBAR and how is it used?
- Detailed description on each section of the SBAR
- SBAR Example for Nurse-to-Physician Communication
SBAR Nursing Communication
What is SBAR? It’s a communication method used to promote and simplify communicating important patient information to other members of the healthcare team.
The SBAR method strategically helps communicate a specific patient situation along with the patient’s background, your assessment, and possible recommendations. Really the goal of the SBAR is to systematize and make communication more consistent.
It helps remove all the fluff and/or unorganized thought that may occur when communicating with others about a patient. Furthermore, it helps the nurse focus on the problem at hand, be organized, and helps the listener determine what the nurse is trying to convey. Plus, if the listener (like the doctor) has questions about the patient that information should be easily accessible so the nurse can quickly respond to the doctor’s questions.
SBAR is an acronym that stands for:
Situation, Background, Assessment, Recommendation
Examples for the usage of the SBAR:
- Nurse-to-provider communication
- Used to help the nurse when calling to report a patient’s deteriorating condition or requesting something for the patient
- Nurse-to-Nurse or other nursing staff
- during transfers to other units or patient report hand-offs
- It can also be used with other members of the healthcare team like physical therapy, speech therapy etc.
When creating the SBAR:
- Use a sheet of paper that helps layout the SBAR. Sometimes units have these available for you to use.
- Be familiar with the patient. It’s very helpful to read the last progress note on the patient and review the patient’s latest labs and procedure results. Plus, make sure you have just assessed the patient.
- Gather all the information you will need before calling or communicating and have it within reach (example: vital signs, important health history, labs, consults, meds (include fluids), allergies, tests (pending, already completed, their results etc.)
What’s included in each SBAR category:
Remember your communication needs to be focused and to the point….remember no fluff:
Situation (why you’re calling them….introduction and get to the point)
- Say hello and the listener’s name along with your name and the unit you’re on, patient’s name, room number, the patient’s current situation (why you’re calling and this should be a short sentence).
Background (focused information that the listener needs to know in order to understand the current patient problem)
- Transition into this part of the conversation by stating the patient’s diagnosis and date of admission.
- As needed you can include important patient health information that is related to the patient’s presenting problem. This may be:
- medications, fluids running, allergies
- code status
- significant health history
- current laboratory testing/procedures results (be sure to know the previous values to see how the values are trending
- and other findings that help them understand the problem)
This information will create a brief description of what has occurred up to this current problem. Again, the information included in this section will depend on why you are calling and who you are talking to.
Assessment (include what you found and what you think may be going on with the patient based on your findings)
- Explain what you think is going on. Is it a cardiac, respiratory, neuro, GI problem?
- Provide assessment findings (current vital signs) to back up what you think is going on.
- What if you don’t know? Just say you’re worried about the patient, the patient is deteriorating or unstable or has changed from their previous status etc.
- Don’t be afraid to state what you think is going on.
Recommendations (state what you would like to be done for the patient)
- Be very specific about what you think the patient needs, if you need further orders, clarification or if the patient needs to be seen. You can recommend more testing, changes in medications, for the patient to be seen, or when you should notify them again etc.
- This can be the hardest part for some nurses because many times the nurse doesn’t feel comfortable or confident enough to give recommendations.
- If you don’t know what to recommend, ask the listener for their recommendations or ask for the patient to be seen as soon as possible.
Once you are done speaking, listen closely to the feedback and write down any new orders you receive. Then read them back to the provider to confirm they are accurate. When the conversation is over be sure to always document and complete the orders.
SBAR Example of Nurse-to-Physician Communication
Scenario: A patient was just admitted to your cardiac PCU floor with cardiomyopathy. At mid-noon the patient’s respiratory status has deteriorated and his blood pressure has become elevated. You notify the doctor to report the patient’s condition and request a change to the patient’s medications and further testing.
Situation: Hello, Dr. Ross. This is Sarah from 1800 the Cardiac PCU floor. I’m taking care of Mr. Morris in Room 1802. I’m concerned about the patient’s recent development of dyspnea and hypertension.
Background: He was admitted early this morning and has a diagnosis of cardiomyopathy. He has a history of coronary artery disease, hypertension, and aortic valve disease. Medications he is currently ordered are Lisinopril 10 mg PO Daily and Furosemide 20 mg PO BID.
Assessment: He has developed crackles throughout his lung fields, especially in the right and left lower lobes. His oxygen saturation has dropped from 95% to 87% on 2L nasal cannula and his current respiratory rate is 28. When he speaks or performs any type of physical exertion he becomes extremely short of breath. He has 3+ pitting edema in the lower extremities and a current blood pressure of 200/120 and heart rate 102. I think he is experiencing fluid volume overload which may be contributing to the patient’s respiratory and cardiac issues.
Recommendations: I think the patient may need an adjustment in medications and further diagnostic testing. How would you like me to proceed with this patient? Do you want me to order a change in medications and/or diagnostic testing like a chest-x-ray, ABGs, cardiac series, echocardiogram to further investigate the patient’s condition?
Read back the orders you received to confirm they are correct. The document and complete the orders.
Martin HA, Ciurzynski SM. Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department. Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association. 2015;41(6):484-8. doi:10.1016/j.jen.2015.05.017.
SBAR a powerful tool to help improve communication. (2013). Retrieved 17 June 2021, from https://www.jointcommission.org/resources/news-and-multimedia/blogs/at-home-with-the-joint-commission/2013/11/sbar–a-powerful-tool-to-help-improve-communication/