SBAR (situation, background, assessment, recommendation)
What is SBAR and how to use SBAR to communicate about unwell patients
SBAR stands for situation; background; assessment; recommendation. It is a technique you can use to frame conversations, especially critical ones, requiring a clinician’s immediate attention and action. It ensures you mention all the most important pieces of information in the most efficient way possible.
It is comprised of four parts:
- S – Situation: What is happening at the present time
- B – Background: What are the circumstances leading up to this situation
- A – Assessment: What you think the problem is
- R – Recommendation: What should we do to correct the problem?
You can either mention these outwardly: “The situation is that…”, “The background is that…” or not mention the titles overtly but still stick to the structure – as in the example below.
Example of SBAR being used
- “Dr. Johnson, this is the A&E nurse Marianne O’Grady, I’m calling about your patient Edward Blacker in bed four.”
Situation
- “Mr Blacker has new chest pain. He’s short of breath and doesn’t look well.”
Background
- “He had a total hip replacement two days ago. About ten minutes ago he began getting chest pain. His pulse is 126, his blood pressure is 116 over 54 and his sats are 92% on air.”
Assessment
- “I’m concerned he may be having a cardiac event or pulmonary embolism.”
Recommendation
- “Please come and see him straight away. I’m going to put him on high flow oxygen and do an ECG, is this OK?”
Video of how to do an efficient SBAR handover
After SBAR
- Always check when the doctor might be able to come and ensure you’ve understood anything else they may have asked for. You can prompt this with: “Is there anything else you’d like me to do?”
- The SBAR technique creates the shared mental communication model that ensures the nurse and doctor (or nurse and nurse / doctor and doctor) remain on the same page throughout the conversation