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In this lesson, we’re going to take a look at SBAR communication.
When we talk about SBAR, what are we talking about?
SBAR is a way to communicate information about patients to other providers. It’s a short, succinct report or communication method which only really highlights the most pertinent information between healthcare providers. If there isn’t any sort of process to communication, it can slow down care or important info doesn’t get to the right people. Check out the patient story attached to this lesson. It’s pretty funny, and it’ll give you a great perspective on why we use SBAR.
SBAR stands for Situation, Background, Assessment, and Recommendation.
The “S” in SBAR stands for situation. What it does it looks at the situation of the patient, or the main reason for the call or report. For instance, if your patient starts complaining of chest pain, that’s the situation: Chest Pain.
When putting it in a report, be objective. “Went to patient’s room, patient complaining of chest pain. States 8/10 chest pain, crushing pain, radiating to left arm.”
Also, use the patient’s identifying info. So name, date of birth, and any other important identifying information.
B stands for background. The main point of this is to give a brief medical history. If a patient is in the hospital, this is where the primary diagnosis or chief complaint would go. This could also be the reason for admission. Also, any recent labs, medications, allergies, and code status would go here. Be sure to include a set of the most recent vital signs. If we look at our patient with chest pain, if they’re admitted for some sort of heart disease, then it helps guide practice. So pay attention to the admitting diagnosis.
The “A” in SBAR is for assessment. This part of SBAR is where an “assessment” of the situation. This is similar to a nursing diagnosis (go check that lesson out if you haven’t seen it). This basically is analyzing the situation to figure out what’s wrong or suspected wrong with the patient. Don’t make a medical diagnosis here. This is just the point where you assess the situation and figure out what you think is going on with the patient, based on the info and your knowledge. If we look at our patient with chest pain, we can infer that they may be having a heart related complication. The other thing you’ll need to do is include any of your own assessment and assessment data to backup your “problem” in this step of the SBAR.
The “R” in SBAR is for recommendations. This is the point in the process where you’ll make recommendations based on what has been assessed. So for the patient with chest pain, the expectation of treatment would be EKG, cardiac markers (labs like trop, etc), maybe full labs, maybe chest xrays. Advocate for your patient. If you think of something that the doctor may not be thinking of, or anticipate care, speak up. This is why multidisciplinary care for patients work; because multiple eyes are on the patient.
There are multiple time when you should use SBAR, and knowing when can be confusing. The most common times you’ll use SBAR is getting report or giving report to the nurse in the operating room. Another time you’d give report in SBAR format would be transferring to an outside facility, like a skilled nursing facility, or when you’re transferring the patient to a lower level care unit, like from ICU to the floor.
Another time you’ll use SBAR, but not in a formal report, would be if you need to communicate to a physician. So if your patient has a new complaint, like the patient with chest pain, you’ll use the SBAR format to call the doctor with the new complaint. This is something that can be really intimidating for nursing students – but SBAR gives you a great structure to know exactly what to say when you call. So let me give you an example of what this might look like.
“Hey Dr Smith, this is the nurse caring for Ms. Johnson in Room 2. She has a new complaint of chest pain, that radiates to the left arm and jaw. She presented yesterday for an exacerbation of congestive heart failure, and has a history of CAD. Her telemetry monitor is showing an ST segment elevation. HR is 110 and BP is 185/115. I’m suspecting an MI, but need to confirm with EKG. Would you like to get cardiac levels and 12-Lead EKG? Also, could you come down and see the patient?”
The other thing you’ll want to do is anticipate information that the doctor wants to know and have the most important and recent information ready. The worst thing is to call a doc and they say “what’s the patient’s Blood Pressure?” and you don’t have it and have to call them back!”. So anticipate! Get all your info before you call and have your SBAR ready!
The nursing concepts for this lesson are communication and teamwork & collaboration.
Ok, let’s recap:
Situation is about what’s going on with the patient. Be sure to identify your patient.
Background tells a brief medical history. Be sure to include recent labs, vitals and any pertinent info.
Assessment is about what you think the problem is.
Speak your mind with your recommendations; it’s about advocating what you expect would help the patient.
Know when to use SBAR and SBAR format when talking about what’s going on with your patient.
That’s all for the lesson for SBAR. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!