SBAR Made Easy

You may see entries in a medical record or forms designed around the abbreviation SBAR.

SBAR was developed by Kaiser Permanente of Colorado and has been increasingly adopted by hospitals through the United States. SBAR is used:

• to report to a healthcare provider a situation that requires immediate action,
• to define the elements of a handoff of a patient from one caregiver to another, such as during transfers from one unit to another or during shift report, and
• in quality improvement reports.

Liability issues may surround the communication that occurred in any clinical situation, but particularly when unexpected changes in a patient’s condition occur. It is often difficult for the attorney to determine what the healthcare prescriber (physician, physician assistant, nurse practitioner) was told. An inexperienced or fatigued nurse may omit specific important information. One of the goals of SBAR is to provide a structure for such communication.

Many facilities use SBAR to communicate in an emergency, as well as at other times. Pronounced S-Bar, this term refers to a methodology that was designed to ensure effective, accurate, mistake-free communication between medical staff and each other as well as with physicians and other healthcare professionals.

What does SBAR mean? It is an acronym for a formalized communication technique that is quickly becoming the standardized method in major hospitals and clinics throughout the United States. It stands for –

• Situation
• Background
• Assessment
• Recommendation

A medical update starts out with describing the situation surrounding the need for care, gives the background pertinent to that care, assesses what needs to be done and provides a recommendation as to a proper plan of action.

Here is an example of SBAR in action when a patient is showing early warning signs.

Barbara Kingsley RN calls Doctor Sarah Smith about her patient Nancy Logan. “Doctor Smith, this is Barbara Kingsley at St. John Health System Riverview Hospital, 2 North. I am calling in reference to your patient, Nancy Logan. Here is the situation: Mrs. Logan is having increased dyspnea.”  (S)

“The supporting background information is this: she had a right arm fracture surgically repaired seven days ago. She was placed on Heparin subcutaneously twice a day for complaints of left leg cramps and a suspected deep vein thrombosis. Her blood pressure had been running 150/90 but it is now 100/50. We’re awaiting the result of an EKG and CT scan that were done this morning. She is now sweating and has a respiratory rate of 40.”  (B)

“My assessment of this situation is that she might be having a pulmonary embolism.” (A)

“I recommend you see her immediately and that we start her on Oxygen 2 liters STAT. Do you agree? Do you have any questions about me?”  (R)

The benefits of SBAR are that it:

• Reduces medical error.
• Promotes clarity of communication between providers
• Fosters effective teamwork.
• Encourages good listening skills.
• Standardizes handoffs.
• Reduces medical and nursing malpractice lawsuits.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.