1. SBAR
A Communication Tool
Revised 2008

2. What is SBAR? Situation, Background, Assessment, Recommendation
Thought organizer
Framework for communication

3. Purpose of SBAR
Provides a consistent way to share critical information
Provides a tool to bridge the difference in communication styles between professionals
Provides a clear template of what kind of information is important

4. Have you ever….
Called a physician and realized you didn’t have all the key information they were asking for?
Found yourself talking to a physician and not really being able to organize or communicate your thoughts effectively?

5. Communication Styles
Nurses are trained to “paint the big picture” – are generally very broad and narrative when describing clinical situations
Physicians are trained to be problem solvers and learn to be concise – “what do you want me to do?”
Different health care workers communicate in different ways – we speak different languages
Complicating factors: gender, national culture, hierarchy, prior relationships.

6. Communication Styles
Nurses are also taught that they don’t “diagnose”, which contributes to the broad and narrative communication style. This leaves the doctor impatiently “waiting to find out what they want”

7. Disorganized Communication
Communication Scenario from the CHR

8. Using SBAR When concerns arise, you need to explain
them quickly and well!
Situation – punch line 5 – 10 sec
Background – context, data, how did we get here?
Assessment and Interventions – what’s the problem, what have you tried?
Recommendation – what should we do?
Refer to handout of tool.

9. Considerations
Have I seen or assessed the client myself before calling?
Has the situation been discussed with the Team Leader, or another RN?
Do I have the following available at my fingertips:
Client’s chart
Current meds
Recent vitals, allergies, labs etc.
Code status

10. Organized Communication
Communication Scenario from the CHR

11. Example - Situation Dr Brain, this is Nurse Jane calling about
Mrs. Smith on 2 East. She is 80 yrs old and
had a total hip replacement 2 weeks ago.
She was started on an IV for dehydration
3 days ago.
√ Her condition has deteriorated – she is complaining of SOB and chest tightness
√ She has a Goals of Care Order R1

12. Background Pertinent History includes congestive heart failure.
√ Vital signs – BP 110/60 P 120 RR 28 Sats 90% 3L NP T 38.2 Pain 4/10
√ Chest sounds – Coarse crackles
√ Skin – Mottled and Diaphoretic

13. Assessment √ I’m worried she is in fluid overload or
√ I’m not sure what the problem is, but the client is having troubles
Could also talk about what you tried so far and if it helped or not.
Is the condition getting worse?

14. Recommendation √ What would you like me to do? or
√ The client needs to be seen immediately, what time can I expect you?
√ If the client’s condition doesn’t improve, when should I call you back?
You might also notify the physician that you are going to be transferring the client to Emergency.

15. Legal Aspects
Tool which provides for consistent communication of critical information
Not a legal document (does not replace charting standards)
Document communications, assessments etc. in TTR