SBAR Practice Scenarios

Objective

Upon completion of this lesson on SBAR communication, nursing students will be able to:

Overview

SBAR report is used in the clinical setting to communication about the patient. Use the scenarios given to practice giving SBAR report.

Nursing Points For SBAR

General SBAR Practice

1. Mrs. T is an 89-year-old woman that arrived in the emergency room by ambulance from her assisted living facility. She is a no-code and no allergies. She had a fall from her bed and has dementia. She is not complaining of pain since given morphine at 1800. The x-ray shows a hip break. Her skin is intact and she is receiving NS in her right forearm. Vital signs are stable and family has been notified by the assisted living that she is in the hospital. Surgery is a possibility for the morning, but the surgeon has not confirmed this yet. The day shift nurse needs to give report to the oncoming night shift nurse.
   1. S- This patient, Mrs. T.is an 89-year-old patient who arrived a few hours ago from her facility after a fall.
   2. B-She has a history of dementia and is a no-code patient with no known allergies.
   3. A-X-ray showed a broken right hip. On assessment, her skin is intact, vitals are stable, she has no current complaints of pain, but did receive morphine at 1800. She has NS infusing in her right forearm and there are no other abnormalities with her assessment.
   4. R-There is a possibility that she might have surgery in the morning so she needs to be kept NPO tonight. I recommend updating the family when we know for sure if surgery will happen.
2. Mr. U is a 69-year-old man that was seen 3-weeks-ago for a gash on his heal that was cultured and showed an infection. He had been scheduled for knee replacement surgery until this occurred and the orthopedic doctor prescribed a course of antibiotics that has been completed. He now has arrived at the emergency room unable to put weight on the leg and walk. He is a full code. His leg and knee are extremely swollen and warm to touch. The skin on the heal is closed and not showing signs of infection. The nurse needs to call the orthopedic doctor and update him.
   1. S- Hi. Dr.____. This is____ and I’m caring for Mr. U who arrived to the emergency room a few minutes ago. He is a 69-year-old patient that you have been caring for.
   2. B-He was originally scheduled for knee surgery a few weeks ago but this was postponed due to an infected gash on his heal that you prescribed antibiotics for.
   3. A-He presents with a large amount of swelling in his left leg and he can not put weight on this leg. It is swollen and warm to touch.
   4. R-Would you like to aspirate fluid to culture and/or have an x-ray done?
3. Mrs. W is a 62-year-old woman who arrived to the emergency room by ambulance. The EMT explains that she had felt funny and started to shake and convulse. Potassium is 3.0 mEq/L and the client reports having blood in the stool. Blood sugar is 78mg/dl. She is extremely tired and has a headache. Mrs. W is allergic to sulfa. The nurse needs to update the doctor on the patient’s arrival.
   1. S- Dr.___ Mrs. W arrived from the ambulance after convulsing at home. Her lab work came back and her potassium is low a 3.0 mEq/L.
   2. B-We do not have much of a history yet but the patient is reporting blood in her stool and she is allergic to sulfa.
   3. A- Her blood sugar has been checked and within normal limits. She is complaining of a headache and appears postictal.
   4. R-Do you want us to give her some potassium replacement and send a stool sample. Do you want to do a CT scan for the convulsions or an EEG?
4. Ms. M is a 20-year-old patient who went to the doctor’s office for complaints of a weight loss of 20lbs in a month and feeling extreme fatigue and dry mouth. The healthcare provider has the office nurse check the blood sugar and urine. The patient’s blood sugar is 402mg/dl and ketones are found in the urine. The healthcare provider let’s the patient know that she is diabetic and will be transferred to the hospital and admitted. Ms. M has no known allergies. The nurse at the doctor’s office calls to give report to the nurse receiving the patient at the hospital.
   1. S- Ms. M arrived at the Doctor’s office this morning with ketones in her urine and blood sugar of 402 mg/dl and was diagnosed with Diabetes. She will be at the hospital soon as a direct admit for treatment and management.
   2. B- She has no other history or allergies.
   3. A- She reports a 20lb weight loss over the last month, frequent urination, excessive thirst We checked her urine and blood sugar.
   4. R- She will need education on diet and insulin management.
5. Mrs. R, a 75-year-old female, was admitted to the medical-surgical unit from a skilled nursing facility. She has a history of chronic obstructive pulmonary disease (COPD) and was previously diagnosed with hypertension. Her primary complaint is increasing shortness of breath and chest tightness over the last 24 hours, accompanied by a productive cough with yellow-green sputum.SBAR Report:S – Situation: Mrs. R, a 75-year-old patient with a history of COPD and hypertension, was admitted from a skilled nursing facility. She presents with worsening shortness of breath, chest tightness, and productive cough with yellow-green sputum for the past 24 hours.

   B – Background: Mrs. R’s medical history includes COPD and hypertension. She is on a daily regimen of albuterol inhalers and lisinopril for hypertension. No known allergies are reported.

   A – Assessment: On examination, Mrs. R appears to be in moderate respiratory distress with increased work of breathing. Her oxygen saturation is 88% on room air, heart rate is 100 bpm, respiratory rate is 28 bpm, and blood pressure is 150/90 mmHg. Lung auscultation reveals bilateral wheezing and coarse crackles in the lower lobes. Mrs. R reports an increase in sputum production with a change in color. She denies chest pain or palpitations.

   R – Recommendation: Given her worsening respiratory status, we recommend initiating nebulized albuterol treatments and administering oxygen at 2 liters per minute via nasal cannula to maintain oxygen saturation above 92%. A chest X-ray may be considered to rule out any acute lung pathology. Please assess her response to treatment and consider adjusting therapy accordingly. Additionally, it’s important to obtain a detailed medical history from the skilled nursing facility to understand her baseline condition and any recent changes in her care plan.

Frequently Asked Questions Regarding SBAR

1. What is SBAR report?
   1. SBAR report is a structured communication method commonly used in healthcare, especially among nurses and other healthcare professionals, to convey important patient information efficiently and accurately. The acronym “SBAR” stands for:
      1. Situation: This is where the nurse or healthcare provider briefly describes the current situation or the reason for the communication. It typically includes the patient’s name, age, and any relevant background information.
      2. Background: In this section, the communicator provides essential background information about the patient’s medical history, relevant diagnoses, allergies, and medications. This helps the receiving healthcare provider understand the patient’s context.
      3. Assessment: Here, the communicator shares their assessment of the patient’s current condition, including vital signs, symptoms, and any changes since the last assessment. This section provides an overview of the patient’s clinical status.
      4. Recommendation: The final part of the SBAR report involves offering recommendations or requests. This could include suggesting a specific intervention, ordering a test, or seeking guidance from a higher-level healthcare provider.

      SBAR reports are used during handoffs, patient transfers, and when communicating critical information to ensure that all essential details are conveyed clearly, reducing the risk of miscommunication and improving patient safety. It’s a structured framework that enhances communication and promotes efficient teamwork in healthcare settings.

2. What is the purpose of SBAR report?
   1. The purpose of SBAR (Situation, Background, Assessment, Recommendation) in healthcare communication is to provide a structured and standardized framework for conveying critical information effectively and efficiently. SBAR serves several key purposes:
      1. Clarity and Consistency: SBAR ensures that healthcare professionals communicate information in a consistent and organized manner. This reduces the risk of misunderstandings, errors, and miscommunication, which can have serious consequences for patient care.
      2. Enhanced Patient Safety: By following the SBAR format, healthcare providers can convey vital patient information, including changes in condition, medical history, and recommended actions, with precision. This promotes patient safety by ensuring that all necessary details are communicated accurately.
      3. Efficient Communication: SBAR streamlines communication during handoffs, patient transfers, and when reporting critical situations. It allows for the rapid exchange of information, enabling healthcare teams to make timely decisions and provide appropriate care.
      4. Improved Interprofessional Collaboration: SBAR facilitates effective communication between different members of the healthcare team, such as nurses, physicians, and other providers. It promotes collaboration by ensuring that everyone is on the same page regarding a patient’s condition and care plan.
      5. Reduced Cognitive Load: Healthcare professionals often work in high-pressure environments. SBAR helps reduce cognitive load by providing a structured format that guides them in conveying information systematically, even during stressful situations.
      6. Enhanced Documentation: SBAR can also be used as a tool for documenting patient handoffs and important conversations. This documentation can serve as a reference for future care decisions and legal purposes.

      Overall, the purpose of SBAR is to improve patient outcomes by promoting effective communication, reducing the risk of errors, and ensuring that healthcare providers have the information they need to make informed decisions about patient care.

Reviewed by: Jon Haws, RN, BSN, CCRN Alumnus

Last Reviewed: September 14, 2023