SBAR Communication for Nurse to Physician Communication

Overview

• Speaker: Sarah, Registered Nurse (RN)
• Topic: SBAR (Situation, Background, Assessment, Recommendation) method for effective nurse to physician communication
• Purpose: To communicate patient information clearly and concisely, improving understanding and efficiency among healthcare team members.

SBAR Breakdown

• S: Situation
• B: Background
• A: Assessment
• R: Recommendation

Purpose of SBAR

• Helps to systematize and streamline communication about patient conditions
• Ensures clear and focused exchange of information without unnecessary details (fluff)
• Helps nurses stay organized and prepared, reducing uncertainty and improving response times

When to Use SBAR

• Nurse to physician, nurse practitioner, or physician assistant communication
• Nurse to nurse (e.g., shift report or patient handoff)
• Communication with other healthcare team members (e.g., speech therapy, occupational therapy, physical therapy)

Preparation for SBAR

• Gather Information: Review patient chart, assess patient, check vital signs, recent lab results, medications, progress notes
• Documentation: Layout of SBAR form if available, or jot down notes for easy reference during communication
• Accessibility: Ensure all necessary information and tools (computer, papers, etc.) are within reach

Detailed SBAR Components

Situation

• State the purpose of the communication
• Provide a brief introduction:
  • Identify yourself and your unit
  • Patient's name and room number
  • Reason for calling

Background

• Provide a concise summary of the patient's background
• Include relevant information:
  • Diagnosis and date of admission
  • Significant health history
  • Current medications, fluids, allergies
  • Test results and procedure outcomes
  • Trends in lab results (e.g., Hb/Hct levels)
  • Other consults and pending procedures

Assessment

• Share your assessment findings and your interpretation:
  • Vital signs, physical exam findings
  • Opinion on possible issues (e.g., respiratory, cardiac, GI)
  • If unsure, state that the patient is stable/unstable, deteriorating, or there's a change in status

Recommendation

• Specify what you need or expect from the communication:
  • New orders, tests, procedures, medication adjustments
  • Clarification of existing orders
  • Request for the physician to see the patient
  • Ask for recommendations if uncertain

Example Scenario

Scenario Details

• Setting: Cardiac PCU
• Patient: Admitted with cardiomyopathy
• Issue: Developed difficulty breathing, elevated blood pressure, potential fluid overload

SBAR Application

Situation: "Hello Dr. Ross, this is Sarah from the cardiac PCU, caring for Mr. Morris in room 1802. I'm concerned about his recent development of dyspnea and hypertension."

Background: "He was admitted this morning with cardiomyopathy and has a history of coronary artery disease, hypertension, and aortic valve disease. Current medications include lisinopril and furosemide."

Assessment: "He has crackles in his lung fields, O2 saturation dropped to 87%, respiratory rate is 28, and he has 3+ pitting edema. Blood pressure is 200/120, heart rate is 102 regular sinus tach. I think he's experiencing fluid overload impacting his respiratory and cardiac status."

Recommendation: "I think he needs an adjustment in medications and further diagnostic testing. How would you like to proceed? Should we order a chest X-ray, ABGs, echo, or other diagnostics?"

Post-Communication: Read back any orders given, complete tasks, and document the communication properly

Conclusion

• SBAR is a vital tool for structured and efficient communication in healthcare settings
• Regular practice and preparation can help nurses effectively convey patient information and improve patient outcomes

Additional Resources

• More videos available in the provided YouTube description