SBAR Communication for Nurses

Communication failures are a leading contributing factor in adverse patient events. SBAR provides a shared mental model for healthcare communication — a predictable structure that allows the receiver to anticipate and process information efficiently. When nurses call providers, hand off patients, or escalate concerns, SBAR ensures no critical information is omitted.

SBAR is used in all clinical settings: acute care, critical care, long-term care, outpatient, and across all disciplines. It is embedded in Joint Commission safety standards and is a foundational skill for every nurse.

• Reduces errors: Standardized format minimizes omissions of critical information
• Builds confidence: Nurses who use SBAR communicate more clearly and assertively with providers
• Saves time: Structured communication is more efficient than unstructured conversation
• NCLEX relevance: SBAR questions appear in prioritization, delegation, and communication scenarios

S — Situation

State who you are, who the patient is, and what is happening right now. Be direct and concise — the situation statement is the reason for the call.

• Your name and unit/location
• Patient name, age, and room number
• The immediate concern or change: "I am calling about a change in condition" or "I am concerned about..."
• One to two sentences maximum — do not explain history here

Example: "Dr. Smith, this is Nurse Chen calling from 4 West. I am calling about Mr. Garcia in Room 412, a 68-year-old post-op day 2 patient. He has developed acute respiratory distress in the past 30 minutes."

B — Background

Provide the relevant clinical context — the information the provider needs to understand the situation. Keep it focused on what is pertinent to the current concern.

• Admitting diagnosis and reason for hospitalization
• Relevant medical history and comorbidities
• Current medications relevant to the issue
• Most recent relevant vital signs, labs, or assessment findings before the change
• Allergies if relevant

Example: "He was admitted for right hip replacement. PMH includes hypertension and COPD. He is on aspirin, lisinopril, and albuterol PRN. Baseline O2 sat was 96% on room air this morning. He has a history of DVT five years ago."

A — Assessment

State your clinical assessment — what you think is happening. This is where nurses often hesitate, but providing your assessment is expected and professional. It does not need to be a diagnosis — it is your clinical impression.

• Current vital signs and objective findings
• Your clinical impression of what may be occurring
• Level of urgency or concern
• Changes from baseline

Example: "Currently his O2 sat is 88% on 2L nasal cannula, RR 28, HR 118, BP 148/92. He is using accessory muscles and is visibly anxious. He reports pleuritic chest pain. I am concerned this may be a pulmonary embolism."

R — Recommendation

State what you need or recommend. Be specific about what you are requesting — a bedside evaluation, an order, a medication, or a transfer. This makes the communication actionable and avoids ambiguity about next steps.

• What specific action are you requesting?
• What do you need the provider to do?
• What have you already initiated (e.g., oxygen, positioning, IV access)?
• If unclear what is needed, ask: "What would you like me to do?"

Example: "I have increased his oxygen to 4L via nasal cannula and have IV access. I'd like you to come evaluate him and consider ordering a CT pulmonary angiogram and anticoagulation. Do you want me to draw stat labs as well?"

Shift Handoff (SBAR Report)

SBAR structures shift-to-shift handoff to ensure the oncoming nurse receives complete, organized information. Bedside shift report using SBAR is a patient safety best practice recommended by The Joint Commission.

• Situation: Patient name, age, day of admission, admitting diagnosis
• Background: Medical history, code status, allergies, current IV access and infusions
• Assessment: Current vital signs, assessment findings, pain level, I&O, pending labs/tests
• Recommendation: What needs follow-up, pending orders, patient/family concerns, goals for next shift

Rapid Response Communication

When calling a rapid response or code, SBAR must be delivered rapidly and precisely. Preparation before calling is essential — gather vital signs, assessment findings, and patient history before picking up the phone.

• Have the chart or EHR open and at hand before calling
• Know the patient's code status before escalating
• Document the SBAR communication with time, provider name, and response received
• If the provider's response is inadequate and you remain concerned, escalate through the chain of command

• Prepare before calling — gather all relevant information, vital signs, and chart data first
• Anticipate what the provider may ask: recent labs, last medication given, patient allergies, IV access
• State your recommendation confidently — providers expect it and it makes the call more efficient
• Use read-back for all telephone orders to confirm accuracy
• Document the SBAR call completely: who you called, time, information provided, orders received, and any follow-up actions
• If a call is dismissed but your clinical concern persists, escalate — use the chain of command without hesitation

• Calling without preparation: Not having vital signs, chart, or relevant info ready before calling leads to incomplete communication
• Omitting the Assessment: Stating findings but offering no clinical impression leaves the provider without the nurse's expert input
• Vague recommendations: "I just thought you should know" fails to make the communication actionable
• Not documenting the call: Without documentation, there is no record of the communication or the response received
• Abandoning the chain of command: If the first provider does not respond appropriately, escalation is required — patient safety takes priority