SBAR – The Communication Standard in Healthcare
Clear communication is not optional - especially when patient care is on the line.
Across healthcare settings, when a nurse identifies a change in a patient’s condition, the expectation is clear: the provider must be notified. Research consistently shows that in high-pressure clinical environments, where minutes can mean the difference between a good outcome vs. a poor outcome, using a standardized method of clear, concise communication is best practice.
SBAR is an acronym for Situation, Background, Assessment, and Recommendation. It is an evidence-based communication framework designed to ensure that critical information is conveyed efficiently, accurately, and in a manner that supports timely clinical decision-making.
In this overview, we will focus on how SBAR is used by a nurse to communicate a change in condition to a provider. The following case is entirely fictional but reflects the standard of care following a fall in a post-acute rehabilitation or long-term care setting.
Clinical Scenario
A nurse working in a post-acute rehabilitation facility discovers that a resident has fallen while attempting to transfer from his bed to a chair. The nurse completes an immediate assessment, obtains vital signs, and notifies the on-call provider.
S – Situation
The nurse begins with a clear, concise statement of why the provider is being contacted:
“Hello, Dr. Doctor. This is Nurse from Rehab Facility. I am calling about a 70-year-old male resident who fell while attempting to transfer from his bed to a chair.”
B – Background
Next, the nurse provides relevant clinical context that may influence medical decision-making:
“Mr. Resident was admitted to Facility on this date. He has a past medical history of atrial fibrillation and suffered a stroke approximately six months ago, with residual right-sided weakness. He is currently prescribed and taking an anticoagulant.”
A – Assessment
The nurse then reports objective data and assessment findings, emphasizing abnormalities:
“Mr. Resident’s current vitals are as follows: temperature 98.6°F, pulse 91 bpm, respirations 18, oxygen saturation 95% on room air, and blood pressure 131/85. He is alert and oriented x3. He reports striking his head during the fall and rates his pain as 5/10 at the left temple. Pupils are equal, round, and reactive. There is localized redness and tenderness at the left temple with intact skin. Strength and range of motion in all extremities are at baseline. No additional pain, bruising, or deformities are noted.”
R – Recommendation
After the provider has been informed of the situation, background, and assessment, the nurse should communicate what they are requesting from the provider. Nurses should be familiar with facility policies and prepared to implement provider orders promptly:
“Would you consider ordering Tylenol for pain control as well as an order to apply an ice pack as needed? Per facility policy, we will begin neurologic checks, however this policy also states that residents on anticoagulation who fall and sustain impact to the head should have a head CT.”
Why SBAR Matters
As demonstrated in this scenario, clear and structured communication allows the provider to make informed clinical decisions. If any component of the SBAR report were omitted or communicated inaccurately, the provider would be working with incomplete information, potentially leading to delays in care, inappropriate treatment, or adverse outcomes.
From a medical-legal perspective, SBAR supports not only patient safety but also optimal clinical practice by creating a clear record of assessment, escalation, and decision-making aligned with evidence-based standards of care.
SBAR is not just a communication tool - it is a safeguard for patients and clinicians alike.
References:
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC5123547/#sec1-5
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC6112409
3. https://www.sciencedirect.com/science/article/pii/S2514664524008403