APPENDIX A

Guidelines for Communicating Using the SBAR

Various procedures, models, and policies have been adopted by health care organizations to meet the safety goals. One model used for telephone reporting and hand-off communication is the SBAR (Situation-BackgroundAssessment-Recommendation) technique for communication. This technique provides a mechanism to use for framing communication between members of the health care team about a patient s condition, especially one that is critical. SBAR is a model for effective information transfer by providing a standardized structure for concise factual communications from nurse to nurse, nurse to physician, or nurse to other health professionals. Before calling a physician about a patient problem, assess the patient yourself, read the most recent physician progress and nursing notes, and have the patient chart available.
S Situation

What is the situation you want to discuss? What is happening at the present time?

v Identify self and unit. State: I am calling about: patient, room number v Briefly state the problem, what it is, when it happened or started, and how severe it is. State: I have just assessed the patient and I am concerned about: identify why you are concerned.
What is the background or circumstances leading up to the situation? State pertinent background information related to the situation that may include:

v Admitting diagnosis and date of admission v List of current medications, allergies, IV fluids v Most recent vital signs

Background

v Date and time of any laboratory testing and results of previous tests for comparison v Synopsis of treatment to date v Code status

A Assessment

What do you think the problem is? What is your assessment of the situation? State what you think the problem is:

v Changes from prior assessments v Patient condition unstable or worsening

R Recommendation/ Request

What should we do to correct the problem? What is your recommendation or request? State your request:

v Specific treatments v Tests needed v Patient needs to be seen now

Q Questions

Read back and review. This is the opportunity to ask clarifying questions and review chart. v Read back specific concerns v Questions asked and answered

v Clarify statements/orders