General
what does SBAR stand for?
Situation, Background, Assessment, and Recommendation
Give 1 component the nurse should address when communicating the "Background" in SBAR
Admitting diagnosis and date of admission.
List of current medications, allergies, and infusions.
Key laboratory testing and results with dates for comparison, most recent vital signs
Code Status
What's wrong with this SBAR?
Mr. Smith, admitted yesterday for chest pain, history of hypertension
He's experiencing shortness of breath, with a respiratory rate of 24 breaths per minute
I recommend administering nitroglycerin sublingually and obtaining a 12-lead ECG to evaluate for possible myocardial infarction
This is Nurse Johnson calling about Mr. Smith in room 305
Wrong order:
Situation component should come first, followed by Background, Assessment, and Recommendation
Give 1 component a nurse should address when communicating the "Situation" in SBAR
•Identify yourself
•Identify the patient your calling about
•What the potential problem
These are all examples of which component of "SBAR"?
Respiratory rate is 24 breaths per minute, with audible wheezing on auscultation
Glasgow Coma Scale score is 12, with sluggish pupillary response
Inspection reveals a 2 cm x 3 cm reddened area with intact skin
Blood pressure is elevated at 160/90 mmHg, with irregular heart rhythm
Assessment
Which component is missing? Situation? Background? Assessment? Recommendation?
Hello, Nurse Saddleback here calling about Mrs. Smith in room 305
Mrs. Smith, a 72-year-old female, admitted 2 days ago with COPD exacerbation. She lives alone
I recommend initiating oxygen therapy and providing nebulized bronchodilators.
"Assessment" component, which typically includes a description of the patient's current clinical status
What should a nurse do following an SBAR conversation with a physician?
DOCUMENT!!!!!
Name 2 specific ways SBAR improves communication in healthcare settings
Betters team dynamics
Reduces number of medical errors
Improves patient outcomes
Reduces communication barriers
Minimizes miscommunications
Directs attention to current issue/problem/ongoing plan of care
Standardized Format–ensuring consistency
Focused on Key Information
Facilitates Prioritization: prioritize information based on its relevance and urgency, ensuring that critical issues are addressed promptly.
Enhances Interdisciplinary Communication–effective communication between different members of the healthcare team, including nurses, physicians, and other allied healthcare professionals
Promotes Active Listening– reducing misunderstandings or misinterpretations.
Fosters Collaboration
Empowers Patients and Families do be involved in care–creating a safe environment for clarification/questions/updates
What's wrong with this SBAR?
I'm calling about Mr. Johnson
Admitted yesterday
Vital signs stable, slight tachycardia
I think we should do ECG monitoring
Vague, omission of relevant data not enough context
Situation: The situation is unclear and lacks context; specify the purpose of the call or the reason for contacting the recipient.
Background: Lacks details such as the reason for admission, relevant medical history, or any recent changes in the patient's condition
Assessment: Vague and doesn't provide specific values or context. Including actual vital sign measurements and any associated symptoms would help better understanding of patient condition
Recommendation: Lacks justification or explanation. Including the rationale behind the recommendation and any specific concerns or observations would enhance communication
Name 2 modifiable roadblocks to adverse patient outcomes from an inadequate SBAR
Lack of knowledge, personnel who are rushed for time, withholding of information, pecking order, defensive behaviors and insecurity, laziness, complacency, poor follow through, fatigue, excess workload, inadequate discharge planning, distractions, conflicts between team members, lack of role clarity, and misunderstandings
Describe 3 scenarios in which SBAR might be utilized
Patient Handoff/Shift Change
Patient Admission
Patient Transfer
Consulting with Specialists
Discussing Lab Results
Reporting Changes in Patient Condition
Requesting Medication Orders
Discharge Planning
What's wrong with this SBAR?
Your patient is Mr. Johnson in room 410
He is a 45-year-old male admitted yesterday for chest pain. He has a history of hypertension, diabetes, and substance abuse. He's been in and out of the hospital multiple times in the past year for similar complaints. He's quite demanding and kept calling all night asking for pain meds. I think he's homeless and possibly a pain medication seeker. I swear no matter how many pain meds I gave him, it was never enough. He's probably an addict
During the shift he complained of severe chest pain, I think it was like an 8 or a 9. I've had to deal with his constant requests for pain medication throughout the night. I stopped giving them at a certain point because I could tell he just wanted his addiction to be fed
I recommend closely monitoring his medication requests. Be prepared for his persistent demands, I just would ignore the call light so he doesn't bother you
this example is exaggerated and not reflective of appropriate professional conduct in a healthcare setting. The nurse gave personal opinions/assumptions, neglected the patient, and recommended the oncoming nurse do the same. Maintaining objectivity, professionalism, and adherence to factual information is essential in SBAR communication
What was SBAR technique was originally used for and by who?
Used by the U.S. military for nuclear submarines
How would you adapt SBAR communication with patients and families? Give 2 examples
Simplify medical terminology
Focus on patient's experiences & concerns
Encourage questions/concerns
Provide resources
Check for understanding
Offer aids: visual, auditory, language translation, demonstrations
Name 3 adverse outcomes that can happen from inadequate SBAR/Communication
1.Delayed or Inappropriate Treatment
2. Misdiagnosis
3.Patient Harm
4.Increased Length of Stay
5.Compromised Patient Safety
6.Communication Disruptions
7.Legal and Ethical Concerns
8. Medication Errors
9. Lack of Continuity of Care
10. Patient Discomfort or Anxiety