The SBAR tool provides guidelines for nurses to communicate effectively and safely with physicians about patient issues. The SBAR framework includes Situation, Background, Assessment, and Recommendation sections. Nurses should identify themselves and the patient, state the problem briefly, provide relevant history and testing results, give their assessment, and make a clear recommendation. Following the SBAR process and having necessary information available helps ensure physicians receive a concise yet comprehensive update on the patient's condition.

2. Background

3. Assessment

4. RecommendationThis SBAR tool was developed by Kaiser Permanente. Please feel free to use and reproduce these materials in the spirit of patient safely, and please retain this footer in the spirit of appropriate recognition.

5. Guidelines for Communicating with Physicians Using SBAR Contact the physician according to physician preference Wait no longer than 5 minutes between attempts Use all modalities before you assume the physician is not responding In emergent situations, use your health care facility’s emergency protocol (resident service, rapid response team)

6. Prior to Calling the Physician Have I seen & assessed the patient myself before calling? Has the situation been discussed with resource nurse? Review the chart for appropriate physician to call. Know the admitting diagnosis and date of admission. Read the most recent MD and nurse progress notes. Have available the following when speaking with the MD: -Patient’s chart -List of current medications, allergies, IV fluids, and labs -Most recent vital signs - Code status

7. SBAR Process - Situation What is the situation you are calling about? Identify self, unit, patient, room number. Briefly state the problem what is it when it happened or started how severe

8. SBAR Process - Background The admitting diagnosis and date of admission List of current medications, allergies, IV fluids, and labs Most recent vital signs Lab results: provide the date and time test was done and results of previous tests for comparison Other clinical information Code status

9. SBAR Process - Assessment What is the nurse’s assessment of the situation

10. SBAR Process - Recommendation What is the nurse’s recommendation or what does he/she want? Examples: Notification that patient has been admitted Patient needs to be seen now Order change Document the change in the patient’s condition and physician notification.

11. Example Situation Background Assessment Recommendation This SBAR tool was developed by Kaiser Permanente. Please feel free to use and reproduce these materials in the spirit of patient safely, and please retain this footer in the spirit of appropriate recognition. http://picasaweb.google.com/lh/photo/pFBcRy8QaANxrFtmmMb89g