SBAR
SBAR Purpose:
The SBAR tool is a strategy to improve communication from clinician to
physician, clinician-to-clinician and/or staff to manager. SBAR was adapted from
the US Navy Nuclear Submarine Service. Submarine officers and crew needed a
situational briefing model to communicate clearly, effectively and efficiently.
SBAR organizes the message in a consistent and concise manner. SBAR has been
adapted successfully into health care.
SBAR:
S = Situation
What is going on with the patient? A concise statement of the problem.
B = Background
What is the clinical background information that is pertinent to the situation?
A = Assessment
What did you find? Analysis and considerations of options.
R = Recommendation
What action/recommendation is needed to correct the problem? What do you
want?
SBAR, the Home Health Connection:
SBAR is perfect for improving communications in a home health agency (HHA).
This simple tool condenses messages so they contain only concise and significant
information about the patient and allows for the clinician to verbalize their
assessment of the situation - what they think is happening and what
recommendations/actions the clinician feels are needed to correct the problem.
SBAR can be a strategy used with physicians to improve communications and
outcomes, including reducing avoidable acute care hospitalizations. SBAR can
also be used between staff and/or management. This tool can help HHAs clearly,
effectively and efficiently express the real message of the patient situation. SBAR
works well for home health aides to communicate to their supervisors or to the
nurse as well as in interdisciplinary communication.
Sequencing & Reinforcing SBAR:
SBAR is a standardized communication tool that is very easy and simple to use. It
is recommended that you start with a small group or office and pilot this method
prior to rolling it out to the entire workforce. During the pilot you can make
necessary changes without any problems. Once you have successfully
implemented it on a small scale you can spread it throughout your organization.
SBAR works well in more complex situations such as designing it to meet the
specifications of a disease management program (refer to COPD example in
package). Always remember to reinforce the new concept to gain behavioral
changes and staff buy-in. This package includes several tools/resources to help
you. These tools should be modified to your agencys specifications.
Time to use SBAR:
When a patient meets the SBAR criteria. SBAR criteria = any change in a
patients condition that you are concerned about and need to call a doctor.
How to use SBAR:
You are concerned about a patients
condition
Is this life threatening? Do you need to call a Medical Emergency?
No
Yes.
Call for help
immediately
Does my patient meet the SBAR Criteria
Yes.
Have you considered all relevant current doctors
orders, clinical pathways orders and protocols?
Yes.
Conduct a thorough Patient Assessment.
Complete the SBAR Communication Tool
Notify NUM/Supervisor of your patients condition and intent to call doctor
Ensure that you have all relevant information
regarding the patient including charts
Ring Doctor and follow SBAR tool for the prompts.
Document on the tool doctors orders, actions and outcomes.
SBAR Interdisciplinary Communication - Skilled Nursing
Use the following SBAR steps to communicate issues, problems or opportunities
for improvement to coworkers or supervisors. SBAR can be applied to both
written and verbal communications.
-
SITUATION State what is happening at the present time that has
warranted the SBAR communication.
Example: Hi Bertha (nursing supervisor) this is Nancy Nurse calling to
report that my patient, Lois Lane, has an elevated blood pressure this
morning. She also verbalized that she had a nosebleed this a.m.
BACKGROUND Explain circumstances leading up to this situation.
Put the situation into context for the reader/listener.
Example: Miss Lanes blood pressure is 188/92 (R) up from 126/80,
186/90 (L). Her pulse has increased from 64 bpm (regular rate and
rhythm) to 98 bpm (regular rate and rhythm). Miss Lane reported one
nosebleed this a.m. that was stopped when ice was applied to the back of
her neck. No other abnormal CPV symptomatology evident during my
assessment. The patient has verbalized that she is slightly nervous and
jumpy but denies any unusual activity or stress.
ASSESSMENT What do you think the problem is?
Example: It is difficult to determine what is going on with the patient
when the only change in her condition is an elevated blood pressure and
what appears to be a panic attack.
RECOMMENDATION What would you do to correct the problem?
Example: I would like you to notify the physician of these findings and
ask if we can have a MSW referral for an evaluation. There may be
something going on in Miss Lanes life that she has not recognized as
causing the possible anxiety attacks. I would also like you to visit the
patient in the a.m. to assess her blood pressure. We will call the physician
tomorrow with our findings to see if he would like to schedule Miss Lane
for an office visit.
Sumber :
Leonard, M., Bonacum, D., Taggart, B. 2006. Using SBAR to Improve
Communication Between Caregivers. Institute for Healthcare Improvement.
Leonard, M. 2006. The SBAR Technique: Improving Verbal Communication and
Teamwork in Clinical Care. PONL Bulletin, 2(1).
Leonard, M., Graham, S., Bonacum, D. 2004. The Human Factor: The Critical
Importance of Teamwork and Communication in Providing Self Care. Qual Saf
Heath Care 2004, 13:i85-i90. BMJ Publishing Group Ltd. and Institute for
Healthcare Improvement.
Maison, D. 2006. The Interdisciplinary Team Perspective. Effective
Communications Are More Important Than Ever, A Physicians Perspective.
Home Healthcare Nurse, 24(3). http://www.homehealthcarenurseonline.com.
Nunes, J. 2005. Patient Safety Leadership Fellowship Learnings Help Put Theory
into Practice. A Newsletter from the National Patient Safety Foundation. 8(3).
http://www.npsf.org.
Quality Insights of Pennsylvania. 2006. Organizational Culture The Path
Through the Woods.
