SBAR stands for Situation, Background, Assessment, and Request. It is a mnemonic used as a memory aid by health care professionals to communicate a clinical situation clearly and effectively.
The first step in the technique is to state the situation. Staff members must be concise and specific when explaining their position. If staff members do not describe the case thoroughly, it may be difficult for higher-level personnel to decipher what they should do next.
The second step of an SBAR is to describe the background information leading up to this situation briefly. This should include what happened before or caused the clinical problem and what treatments and further assessment are required. Background information may consist of history (e.g., TB, cancer, diabetes), physical examination (e.g., increased respiratory rate, increased heart rate), previous assessment (e.g., vital signs at 2 am), and laboratory results (e.g., low HbA1c).
The third step of an SBAR is to provide a brief clinical assessment, i.e., describe the patient’s condition related to the clinical findings, investigations, and treatment provided. The estimate should include the impact on vital signs (e.g., blood pressure 120/80; respiratory rate 28; oxygen saturation 98%), neurological function (e.g., Glasgow Coma Scale), cardiovascular status (i.e., heart rate 100), etc.
The fourth step of an SBAR is to provide a brief list of patient care/management requests to manage this clinical situation. Recognizing that there may be many possible options for treatment, it should include only those essential to managing the clinical situation at hand. Examples of such requests include analgesia, antibiotics, insulin, vaccination, etc.
How To Perform SBAR Step by Step?
1: GATHER PERTINENT INFORMATION
When providing or receiving an SBAR, key concepts to gather are time, location, patient’s chief complaint, vital signs, and any pertinent historical data.
2: DETERMINE IF SBAR IS NECESSARY OR CAN BE POSTPONED
If the situation is stable with no red flags of significant deterioration, it may be best to wait for an SBAR. This also depends on how urgent the problem is, how many patients are present, and if the provider’s knowledge base is lacking.
3: COMPOSE A BRIEF MESSAGE
The first sentence of the message should be the chief complaint or symptom that brought about this SBAR being called out. The second sentence will include background information about the patient. This includes relevant history, chief or presenting complaint, and also pertinent physical or lab findings. This should be written in short form; remember that this message is not for writing an article but to provide important information about the patient concisely.
4: REVIEW CONTENT WITH OTHER MEMBERS OF THE TEAM
Checking with another provider for clarification on something they may know more about is a good strategy when writing an SBAR. This can be especially helpful if the provider is not very familiar with this patient or does not have current knowledge of the patient’s hospitalization. A second opinion from another provider will add to the accuracy and thoroughness of the SBAR.
5: SEEK AND PROVIDE SUPPORT
If the provider is unsure about any aspect of the patient’s care, they should seek help from a team member. This may be an attending physician or another nurse, but it is imperative not to ask for help when needed. It also shows respect for one’s teammates to admit when they do not know something and need help.
6: REPORT FINDINGS IN SBAR AND FOLLOW UP WITH PATIENT’S NURSE
The provider needs to report their conclusions concisely but precisely to be understood by the other health care providers who may be taking over care of this patient after the SBAR is given. Reporting findings will ensure that all pertinent information has been shared with the other providers and improve communication among the patient’s care team members.
7: UPDATE WHEN NEEDED
It may be necessary to update a provider on a patient’s status before a scheduled SBAR because an update may be needed. If the patient’s situation has changed since the previous SBAR, it is essential to provide this updated information as soon as possible.
8: REMAIN CALM AND COLLECTED
It can be very challenging to remain calm when providing incorrect care to a patient. Still, if the provider can gather pertinent information and provide a clear SBAR, they will not have to worry that their mistakes may be caught. Also, if a provider can remain calm and collected during the SBAR process, they respect their patience and their teammates.
THINGS TO CONSIDER BEFORE PERFORMING SBAR
Why Do You Need To Use SBAR?
SBAR is a reporting tool for the clinical staff, primarily nursing and physicians, to communicate effectively across all levels of patient care (hospital wards through ICUs) with non-clinical hospital teams (administration; finance; lab; etc.). Before using any communication tool, it is essential to know how it will be used, why it is needed, and who will benefit the most from its implementation.
What Can Go Wrong While Performing SBAR?
SBAR is an excellent tool for effective communication. However, it is not without faults. SBAR can negatively impact patient care by decreasing the quality of information passed from one team to another if misused. Hospital staff must understand using SBAR and receive ongoing training, support, and supervision to mitigate this potential pitfall.
How Will You Know If SBAR is Working?
Many hospitals choose to implement the SBAR tool within their Clinical Communication Program (CCP), which already has ongoing safety culture assessments and analyses. Within this safety culture assessment, clinical staff can measure how many times they use SBAR and the success rate. If hospital staff is using SBAR effectively, there should be no discrepancy in information across all levels of the hospital.
Have You Opened the Listener’s Mind?
SBAR is a potent reporting tool to communicate information, but it does not mean that everyone will be receptive to the message. Before using the SBAR tool in your reporting, make sure you have “opened the listener’s mind” by telling them something new and vital. For example, suppose you use SBAR to report that a patient has received their antibiotics on time. In that case, the listener may already be closed-minded because they know that the patient should have received the antibiotic 4 hours ago.
When do You Use Each Step?
The SBAR reporting tool has four parts:[S] Situation, [B] Background, [A] Assessment, and [R] Recommendation. Before a staff member chooses a tool to communicate information about a patient’s care, they need to know when each step is applicable in the SBAR framework.