SBAR in Nursing: How to Use It for Calls and Handover
SBAR stands for Situation, Background, Assessment, Recommendation. It gives urgent or important communication a predictable order so the listener gets the key facts quickly and knows what you are asking for.
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Where SBAR comes from
SBAR was adapted for healthcare from military communication and spread widely through hospital patient safety programs. It is included in teamwork training such as AHRQ's TeamSTEPPS.
The four parts
- Situation: who you are, the patient, and what is happening now, in one or two sentences
- Background: relevant diagnosis, history and recent changes
- Assessment: your findings and what you think the problem is
- Recommendation: what you need, such as a review, an order or a transfer, and how soon
Before you call
Have the record, the latest vital signs, current medications, allergies and recent results in front of you. Know the code status. Decide what you are going to ask for before you dial.
A fictional example
S: 'This is the nurse on Ward 4 calling about the patient in bed 12. Her blood pressure has dropped to 88/50.' B: 'She is day 2 after a fictional bowel resection and was 124/70 four hours ago.' A: 'HR is 118, she is pale and her urine output has been low for two hours. I am concerned she may be bleeding or dehydrated.' R: 'I would like you to review her within 15 minutes. Do you want bloods or fluids started in the meantime?'
Close the loop
Read back any verbal orders, document the call with time and response, and escalate further if the agreed review does not happen.