What is SBAR in Nursing?
Quick, efficient, and clear communication from and between healthcare professionals is integral to treating and caring for patients. SBAR is an effective and easy-to-use communication tool that divides patient status points to be conveyed into categories.
The use of the standardized technique is particularly helpful for nurses, who can use it to organize their thoughts and break vital information into segments that describe the,
- S - Situation
- B - Background
- A - Assessment
- R - Recommendation
By incorporating the SBAR framework into your mindset and practice, you provide yourself and those with whom you are communicating a concise and easily accessible summary of:
- What is happening with a patient
- What led up to the current situation
- Your professional assessment of the patient’s condition
- What you think should happen next
SBAR focuses on what is most relevant, eliminating extraneous detail. It is always helpful, but particularly so in emergent and high-stress situations where minimizing frustration and maximizing clarity is essential.
What Is SBAR Used For?
SBAR can be used to communicate information between healthcare professionals, i.e., from nurse to physician or allied healthcare professional, as well as when relaying information to a patient or their caregivers.
It is commonly used during shift change between nurses as well as when transferring a patient to other units.
- For example, a nurse will use SBAR when a patient is being transferred to a higher (med-surg to ICU) or lower level of care (ICU to med-surg)
Additionally, during a code event, SBAR can be helpful in delivering concise and relevant information.
- SBAR communication is broken down into defined categories that stress concise language. Every important point is included in a simple and straightforward way that saves time, reduces the need for questions, and improves understanding.
SBAR is particularly effective for emergent situations, but is also useful when:
- A patient is first being admitted
- When a patient is being transferred from one care unit or team to another
- When a new nursing shift arrives and needs to be apprised of a patient’s condition
- For updating the patient or their family members about their current status and care plan
What Does SBAR Stand For?
SBAR emphasizes observation, critical thinking, decision-making, and communication. The acronym stands for:
• S = Situation
A brief description and summary of who the patient is and what is happening with them. It may include the patient’s name, age, room number or care unit, as well as who you are and the role you play in the patient’s care.
• B = Background
Brief synopsis of the patient’s history. This may include date and time of admission, admitting diagnosis, lab and diagnostic test results, and changes in status.
• A = Assessment
Professional nursing opinion of what is happening.
• R = Recommendation
Professional nursing recommendations for the next steps based on your knowledge of the patient, your assessment of their status, and all relevant data.
How to Use SBAR for Communication
There are many templates available to guide you through the use of SBAR, but committing the easy-to-remember organizational framework to memory will help you standardize its use for communicating about your patients.
SBAR helps you prioritize and organize what is most critical about each individual patient’s situation, regardless of whether you are explaining it in person, on the phone, or in writing. Its use ensures that the most vital information is relayed quickly so that appropriate action can be taken.
The most important things for you to remember when using SBAR are:
- Keep all points relevant
- Keep all points concise
- Eliminate unnecessary information
The information conveyed via SBAR is meant to be comprehensive, but not overly detailed. It may invite additional questions that you should be prepared to answer, but even without those questions being asked should serve to provide enough information for another healthcare professional to move forward.
It’s also important to note that the recommendations may include medical interventions (such as medication recommendations, radiology, or lab draws) but ultimately it is up to the medical provider to place orders for the patient and determine the next steps.
Nurses are often asked for their professional recommendations because they spend the most time with the patient and might be picking up on subtle cues from the patient.
Emergency nurse using SBAR framework regarding a pediatric patient admitted with vomiting and abdominal pain
Here is how the nurse would quickly provide information to the pediatrician:
S (Situation): Dr. Smith, this is Lynne in the Emergency Department Five-year-old Julia Baker was brought to the E.R. by her father two hours ago complaining of abdominal pain and experiencing nausea, vomiting, and diarrhea. I would like to update you on her condition and clarify orders.
B (Background): Julia’s father reports that complaints of abdominal pain started this morning and she refused food. Since being admitted her pain has gotten worse (now rated as an 8 out of 10) and is now radiating to the right lower quadrant. Oral fluids were ordered and her fever is 103.2 F orally.
A (Assessment): Julia looks pale, is febrile, and is experiencing increased pain, vomiting, and diarrhea since her time of admission.
R (Recommendation): I believe that Julia should be given intravenous fluids and that an ultrasound should be considered in order to determine whether she has appendicitis.
Evening nurse using SBAR report to convey information to morning shift nurse regarding patient admitted from nursing home
S (Situation): Mr. Goldring is an 83-year-old male in room 212, admitted last night at 23:20. Arrived via ambulance from Woods Manor North Nursing Home where he reportedly fell out of bed.
B (Background): Mr. Goldring is diabetic and has mild dementia. All of his supporting documentation has been entered into his chart, including a DNR. Family was notified of the fall by the nursing home and I contacted his daughter with an update shortly after she was admitted. Expect family to arrive this morning to meet with physician.
A (Assessment): Diagnostic X-rays reveal hip fracture, physical examination shows bruising on thigh, skin intact. Patient reports mild pain, morphine administered at 01:00 by ER staff.
R (Recommendation): Physician consultation with surgeon scheduled for this morning. Continue monitoring for pain, follow-up with surgeon regarding next steps.
History of SBAR
Though SBAR is a healthcare communication tool, its roots lie in the U.S. military.
Before Doug Bonacum joined Kaiser Permanente’s environmental health and safety department, he was a part of the U.S. Navy’s submarine force. While on active duty he used a communication technique he referred to as SBAR to succinctly describe and assess mission-critical information up and down throughout the hierarchy.
Years later when he joined Kaiser, he encountered,
Physicians and nurses complaining about poor communications
Physicians complaining about nurses rambling
Nurses complaining that physicians were not following their recommendations
He recognized that the structured format that had proven successful for the military would also help both the receivers and transmitters of patient information, as well as the patient.
Now Vice President of Safety Management at Kaiser Permanente, he points to the need for the healthcare hierarchy to be “flattened” in the interest of patient safety, and credits SBAR for accomplishing that goal.
SBAR is an easy-to-remember acronym that helps healthcare professionals communicate quickly, efficiently, and effectively.
When nurses use SBAR, it leverages their experience, their skill, and their critical thinking ability to both assess and make recommendations.
SBAR introduces structure and discipline to healthcare communications.
*This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease.
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