2. 1) Describe the meaning of SBARR
2) Discuss why SBARR is needed
3) Describe the SBARR process
4) Become familiar with the SBARR tool
3. “Communication errors are the root
cause of almost 70% of sentinel
events, and 75% of the patients involved
died,” (Rodgers, 2007).
4. When does it happen?
HAND OFF REPORT
-Clinician to Physician
-Clinician to clinician
5.
6. 1. Communicate interactively
2. Communicate up-to-date information
3. Limit interruptions
4. Allow sufficient time to complete the hand-off.
5. Require a verification process
6. Ensure the receiver of information has the
opportunity to review relevant historical data
7. The beginning of SBAR
“SBAR is a communication format, which
was initially developed by the military
and refined by the aviation industry to
reduce the risks associated with the
transmission of inaccurate and incomplete
information”,(Rodgers, 2007).
8. What does SBARR stand for:
S-Situation
B-Background
A-Assessment
R-Recommendation
R-Read back
9.
10. Name
Medical record number
Age
Diagnosis
Medication list
Allergies
Vital signs
Lab results
Advance Directive
11. Have I seen and assessed the patient
myself before calling?
Review the chart for appropriate physician
to call.
12. Identify self, agency, and patient name
What is going on with the patient that is a cause
for concern. A concise statement of the problem
13. Admitting diagnosis and date of admission
List of current medications, allergies, IV
fluids, etc.
Most recent vital signs
Lab results: provide the date and time test was
done and results of previous tests for comparison
Medical history
Recent clinical findings
Advance Directive/code status
14. What are the clinician’s findings?
What is the analysis and
consideration of options?
Is this problem severe or life
threatening?
15. What action/recommendation is needed to
correct the problem?
What solution can you offer the physician?
What do you need from the physician to
improve the patient’s condition?
In what time frame do you expect this
action to take place?
16. Confirm what you heard.
Repeat what is ordered by the physician.
Reduces errors.
17. Standard of care
Safety and Quality
Not being Communication Being clear with
direct. Between nurse and expectations and
physician/nurse recommendations
Wrong
medication/ Provides safe care
wrong with good outcomes
procedure
Sentinel event with Saves time. Physicians and
poor patient nurses are less frustrated.
outcomes
18.
19. Conclusion
Being concise and accurate with the
information regarding our patients is
essential to positive outcomes. Using
SBARR will improve the communication
between nurses and physicians.
20. For more information please feel free to
contact me at:
Harriet R. Sullivan-Bibee, B.S.N., R.N.
Kaplan University
Harriet Sullivan-Bibee@student.kaplan.edu
21. (2007). Nursing Education Perspectives SBAR for students. 28 (6), p306-306,
1/3p; (AN27779598)
Delmarva foundation and the Maryland Patient safety center.(2007). Handoffs &
Transitions Learning Network. Retrieved from
http://www.marylandpatientsafety.org/html/learning_netwo
k/hts/materials/resources/handoffs/HandoffsStrategiesChart pdf
Rodgers, K.L. (2007).Using the SBAR communication technique to improve
nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
22. Montgomery Learning college (nd). SBAR. Retrieved from
http://warfieldgraphics.com/CLIENTS/SBAR/SBAR%20Worksheet%2
0Kaiser%20 ermanente.pdf
Ohio Kepra (nd). Medicare quality improvement organization. SBAR
communication. Retrieved from
www.snjourney.com/ClinicalInfo/WrAndReport/SBAR.ppt
The Toronto Rehab (2010). No SBAR: Ineffective communication. Retrieved from
http://www.youtube.com/watch?v=CtdNQfKg8&feature=relmfu
The Toronto Rehab (2010). SBAR: Effective communication. Retrieved from
http://www.youtube.com/watch?feature=endscreen&NR=1&v=fsa
EArBy2g
Hinweis der Redaktion
Rodgers, K.L. (2007, March/April).Using the SBAR communication technique to improve nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
It has been identified that hand off communication between clinicians in health care is not accurate and concise regarding patient care.
TheTorontoRehab (2010).No SBAR: Ineffective communication. Retreived from http://www.youtube.com/watch?v=CtdNQ-sfKg8&feature=relmfu
1.) allowing and promoting questions between the giver and receiver of information. 2.) regarding care, treatment, services, condition, and recent or anticipated changes. 3.) to avoid losing or skewing the information shared. 4.) Don’t be rushed, have plenty of time to discuss the situation. 5.) repeat-backs or read-backs as appropriate. 6.)including previous care treatment protocols. Delmarva foundation and the Maryland Patient safety center.(2007). Handoffs & Transitions Learning Network. Retrieved from http://www.marylandpatientsafety.org/html/learning_network/hts/materials/resources/handoffs/HandoffsStrategiesChart.pdf
Rodgers, K.L. (2007, March/April).Using the SBAR communication technique to improve nurse-physician phone communication: A pilot study. Viewpoint, 7-9.
This is a tool that is typically used for nurses to help provide an outline to communicate with the physician. Montgomery Learning college (nd). SBAR. Retrieved fromhttp://warfieldgraphics.com/CLIENTS/SBAR/SBAR%20Worksheet%20Kaiser%20Permanente.pdf
Before making contact with a physician or giving a hand off report be sure to have the patients information available to you.
Assess the patient prior to calling the physician, the more accurate details that can be provided the better.
Situation – This is Harriet Sullivan-Bibee RN, on 2 East. I am calling about Mr. Mitchell. I am concerned with his vital signs and his worsening condition.
Background – admitted on 6/26 diagnosis is sepsis UTI, NKA. Currently on Levaquin 500mg IV daily. Vital signs are 103 F., 120, 20, 154/90, 91% r/a. WBC-21.00 this am, blood and urine cultures are pending.Past medical history is chronic foley r/t urinary retention.Urine is cloudy with sediment.Full code.
Assessment – My findings are fever, cloudy/sediment urine, and tachycardia. No change in mental status noted. I believe the anti-biotic is resistant. The patient is not improving. I am concerned he could become septic.
Recommendation – would be what the nurse is directly asking for. Do you want blood cultures stat, I would suggest an order for Tylenol, and possibly alt this with Motrin? Do you want to change the foleycath?
Read back – the nurse would then read back the MD’s orders. “Ok, obtain blood cultures x 2 stat, give Tylenol 650mg po every 4 hrs prn temp, and alternate with Motrin 600mg po every 6hrs for a temp greater than 101.5. Thank you.”