SBAR in Nursing: Examples and Tips

SBAR stands for Situation, Background, Assessment and Recommendation. It is a structured way to communicate about a patient so the person on the other end gets the important information quickly, in a predictable order, and knows exactly what you are asking for. Nurses use it for calls to providers, rapid response calls, escalations to the charge nurse and handoffs.

The four parts

Many facilities use a variation such as ISBAR, which adds Identify (who you are, where you are calling from, and which patient), or add a read-back at the end. Use the version your facility teaches.

Before you pick up the phone

A good SBAR call starts before you dial:

• Assess the patient yourself, including a fresh set of vital signs.
• Check recent labs, medications given, intake and output, and the latest notes.
• Know the code status, allergies and admitting diagnosis.
• Have the chart open in front of you.
• Decide what you want to ask for.
• Make sure you are calling the right provider for this patient and this problem.

Example 1: A change in condition overnight

The patient and details below are made up to illustrate the format.

S: "This is [your name], the night nurse on 4 West, calling about the patient in room 412. His heart rate has gone up and his blood pressure has dropped over the last two hours, and I'm concerned."

B: "He's 68, post-op day one from a right hip replacement, with a history of hypertension and type 2 diabetes. His vitals at 8 p.m. were in his usual range."

A: "Now his heart rate is 118 and his blood pressure is 92/54. He's restless, his skin is cool, his urine output has been low since about 10 p.m., and there's new drainage on his dressing. I'm worried he could be bleeding or developing an infection, and I think he's getting worse."

R: "I'd like you to come and evaluate him now. Do you want any labs, fluids or other orders while you're on the way? And should I call the rapid response team?"

Notice that the concern comes first, the numbers show a trend, and the request is specific. If you are new and this is your first time calling for help like this, read your first rapid response as a new nurse.

Example 2: Escalating to the charge nurse

Also illustrative:

S: "I need help with my patient in room 7. She's more confused than at the start of the shift and she just pulled out her IV."

B: "She's 82 and was admitted yesterday with pneumonia. At handoff she was oriented to person and place."

A: "Her oxygen saturation is lower than this afternoon and she's breathing faster. I don't think this is just sundowning, and I'm not comfortable leaving her alone while I pass meds for my other patients."

R: "Can you help me restart her IV, or cover my other patients while I reassess her and call the provider?"

Example 3: SBAR for shift handoff

At handoff the structure shifts toward background and planning, but it still keeps report organized:

• S: Name, age, room, diagnosis, code status, and how the shift went in one sentence.
• B: Relevant history, allergies and key events this admission.
• A: Current status by system, lines and drains, pain, mobility, fall and skin risk, and pending results.
• R: What needs to happen next: labs due, timed medications, discharge plans and anything to watch closely.

A weak call vs a strong call

Weak: "Hi, um, I'm calling about 412. He's post-op, and his heart rate's kind of high, and he's been kind of restless, so I just wanted to let you know." The provider has to drag the story out with questions, and there is no request, so the call can end with nothing done.

Strong: Example 1. It names the concern, gives the trend in numbers, and asks for a specific action.

Tips that make SBAR work

• Lead with your concern. Saying "I'm concerned" or "I think he's getting worse" early sets the urgency.
• Use numbers and trends. "Down from 130s this evening" is more useful than "kind of low."
• Make a specific request. Ask the provider to come see the patient, give orders, or tell you exactly when to call back.
• Read back orders. Repeat verbal and telephone orders back to confirm them, per your facility's policy. For more safe medication habits, see the medication safety champion learning path.
• Agree on follow-up. "If his blood pressure doesn't improve, I'll call you back. Is that right?"
• Escalate if you are still worried. Use your chain of command: charge nurse, rapid response team, supervisor or the next provider level, per policy. TeamSTEPPS teaches the CUS words for this moment: I'm Concerned, I'm Uncomfortable, this is a Safety issue.
• Document the call. Record the time, who you spoke with, what you reported and the response or orders, per facility policy. See nursing documentation tips that protect you.
• Write it down first. For your first several calls, jot your SBAR on paper before you dial. It keeps you focused when you are nervous.

SBAR outside the bedside

The same structure works in emails to your manager, reports to a supervisor about a staffing problem, and even job interviews. When an interviewer asks about a time you recognized a patient getting worse, an SBAR-style story pairs well with the STAR method in behavioral interview questions for nurses. If you are applying now, browse registered nurse jobs and practice telling one clear story about escalating a concern.

Nurses in the med-surg nurses group also share the phrases and templates that work on their units.

Next step

If you are new to calling providers, you are not the only one. Ask questions and share your own SBAR scripts in the new grad nurses group.

General information for nurses, not medical, legal, tax or financial advice. Follow your facility's policies, your state board of nursing and the terms of your employer or contract.