SBAR Nursing Core Competency Inservice
SBAR
Nursing Core Competency Inservice
JANUARY 2020
This guide may not be reproduced, stored in a retrieval system, or transmitted, in any form, in whole or in part, or by any means,
electronic, mechanical, recorded, or otherwise, without the prior written consent of HealthcareSource HR, Inc. The information in this
guide is subject to change without notice. HealthcareSource HR, Inc. assumes no responsibility or liability for any errors, omissions,
assumptions, or any conclusions drawn from this guide. All other third-party trademarks mentioned in this publication are the property of
their respective owner.
HealthcareSource ? 2019
Editor: Tammy McGarity, DNP, MSN, RN, NEA-BC
1
Table of Contents
The SBAR Communication Model ..................................................................................................................... 3
Situation ................................................................................................................................................................. 3
Background ............................................................................................................................................................ 3
Assessment ............................................................................................................................................................. 4
Recommendation ................................................................................................................................................... 4
Scenarios using SBAR ....................................................................................................................................... 4
Hand-off Communication ................................................................................................................................. 5
References ....................................................................................................................................................... 5
HealthcareSource ? 2017
2
The SBAR Communication Model
The Joint Commission, which accredits the majority of hospitals in the United States analyzes the root
causes of sentinel or critical events. Poor communication is the most common cause of patient injury or
death in the clinical setting. SBAR (Pronounced Ess-Bar) is a formalized method of communicating with
other healthcare providers that is becoming increasingly used in many hospitals. SBAR promotes patient
safety by helping 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 by way of a standardized
form of communication helps caregivers speak about patients in a concise and complete way. SBAR is an
acronym for:
?
?
?
?
Situation
Background
Assessment
Recommendation
SBAR was developed by Kaiser Permanente of Colorado, and has been increasingly adopted by hospitals
throughout the United States. SBAR is used to report to a healthcare provider a situation that requires
immediate action, and to define the elements of a hand off of a patient from one caregiver to another (for
example, during transfers from one unit to another or during shift report, and in quality improvement
reports).
Liability issues may surround the communication that occurred in any clinical situation, particularly when
unexpected changes in a patient's condition occur. It is often difficult to determine what the healthcare
prescriber (physician, physician assistant, nurse practitioner) was told. An inexperienced or fatigued
nurse may omit specific important information. One of the goals of SBAR is to provide a structure for
such communication. The elements of SBAR are explained below and applied to contacting a healthcare
prescriber.
Situation
When calling a healthcare provider to report a change in the patient's condition, the nurse identifies his or
her name and unit, the name and room number of the patient, and the problem. The nurse describes what
is happening at the present time that has warranted the SBAR communication.
Background
The nurse includes relevant background information specific to the situation. For example, this could
include the patient's diagnosis, his mental status, current vital signs, complaints, pain level, and physical
assessment findings.
HealthcareSource ? 2017
3
Assessment
This step of the communication provides the nurse with the opportunity to offer an analysis of the problem.
If the situation is unclear, the nurse tries to isolate the problem to the body system that might be involved
and describes the seriousness of the problem.
Recommendation
The nurse states what he or she thinks would help resolve the situation or what is the desired response.
This might be phrased in the form of a question: "Do you think we should give him a medication, perform
lab work, do an xray, perform cardiac monitoring, or transfer to another unit? Will you come to evaluate
him?"
Scenarios using SBAR
Situation: "Dr. Jones, this is Jane Smith, RN, of 5 West. I am calling you to notify you that your patient,
Scott Kelly, in Room 4017-2, fell on the floor today while being transferred out of bed."
Background: "As you know, Mr. Kelly had a laminectomy and bone fusion on January 17. His legs have been
weak since surgery. He fell when our aide was helping him get up with a walker. His current vital signs are
145/90, pulse of 88 and respirations of 20. He is able to move all of his extremities, although he is complaining of
pain at his incision of 7 on a scale from 1-10."
Assessment: "I see no changes in his neurological status since he fell; neither of his legs is shortened and
externally rotated. He is quite anxious now and also worried something in his neck has been injured."
Recommendation: "I believe it would reassure Mr. Kelly if you would examine him. When can we expect you to
come?"
Situation: Dr. White, this is Sue Black, RN, I am calling from ABC Hospital about your patient Sophie Brown.
Mrs. Brown 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.
HealthcareSource ? 2017
4
Hand-off Communication
The safe and effective care of patients depends on consistent, flawless communication between caregivers.
End of shift report, 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. Using the SBAR: Situation, Background, Assessment and
Recommendation model significantly reduces chances of errors in communication.
References
Aiaya, P. (2014, Jun). Culture Trumps Policies. Retrieved Nov 2015, from The Joint Commission,
Leadership Blog:
ANA. (2015). Code of Ethics for Nurses With Interpretive Statements. Retrieved Nov 2015, from American
Nurses Association: of-Ethics-forNurses.html
Beckett, C., & Kipnis, G. (2009). Collaborative Communication: Integrating SBAR to Improve
Quality/Patient Safety. Journal of Healthcare Quality, September/October.
Bramhall, E. (2015, December). Effective communication skills in nursing practice. Retrieved
November
18,
2015,
from
Continuing
Professional
Development:
National Council of State Boards of Nursing. (n.d.). ANA and NCSBN Joint Statement on
Delegation. Retrieved June 2016, from NCSBN:
National Council of State Boards of Nursing. (n.d.). Nurse Practice Act, Rules & Regulations.
Retrieved May 2016, from NCSBN:
National Council of State Boards of Nursing. (n.d.). Working with Others: A Position Paper.
Retrieved June 2016, from NCSBN: Olson,
L., & Stokes, F. (2016, Jul). The ANA Code of Ethics for Nurses With Interpretive Statements: Resource for
Nursing Regulation. Retrieved Aug 2016, from Journal of Nursing Regulation:
8256(16)31073-0/pdf
The Joint Commission. (2014). Hospital Accreditation Standards.
HealthcareSource ? 2017
5
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.