S-BAR

yes, they push it, but everyone pretty much does it their own way where we say dx, HPI, mds, plan, assessment.

seems to be very similar

yes, they push it, but everyone pretty much does it their own way where we say dx, HPI, mds, plan, assessment.

seems to be very similar

They started to require that we all communicate this way-even e-mails-which was helpful. Previously we would get these LONG diatribe e-mails and not get the point (from management, etc.). Now they are in S-BAR format and we know their main point almost right away!

cheers,

otessa

Yep, in clinic I go and see the patient, get the information, do a physical exam, and then give report to the physician. Although we don't have officially use the SBAR format, the report follows the structure because it's the most logical way to convey the information.

Example:

S: I have Mr. Smith in room 2. 47 year old male. Work comp referred him for evaluation of right hand pain.

B: Mr. Smith's job duties include lifting up to 100lbs, welding, and attaching parts at the tractor manufacturing company where he works. He notes bilateral hand pain that began three months ago. Symptoms include...

A: Negative tinel's, negative compression test bilaterally. Mr. Smith states that his pain follows glove distribution.

***At this point the physician knows this patient is probably lying about something.

R: Let's go see the patient. or Should I set up the EMG? or Would you like to review his chart before seeing him?

Even in the clinic, we still need to give all of the important information in a way that makes sense.

I work as an advice/triage nurse in a clinic. We do S-Bar now, though we didn't when I started. Used properly, it is SOOOOO much more effective than the narrative charting/messages we were sending

Great system, SBAR, for communicating with an unfamiliar provider. But before that, I assess the provider's current knowledge. I ask "Do you know [name] in [room number]? Frequent flyer, came in Wednesday night with [condition], [unique memory joggers]?" And I go from there. Saves time.

This was being used at my hospital where I first worked as a nurse and it is the way I learned to communicate on patients. I now work for a hospice, but I use this same format when leaving report on patients or calling doctors. Very helpful, and very anxiety reducing when I was a new nurse and intimidated by doctors.

As a new RN, I used SBAR for my very first call to a doc. He hated it and screamed at the top of his lungs I know my patients. I quickly learned that on this unit the docs find SBAR insulting.

They want us to use it when calling docs and I try, but it is somewhat modified. Sometimes they know the patients and I can leave stuff out. Sometimes they don't so it's helpful to have the information.

So it would come out something like this...."I'm calling about Mr. Smith in room 4103 bed 1. He came in last night with nausea and vomiting. He is currently NPO and diabetic but his blood sugar is 380. He normally takes metformin, but we're holding all PO meds right now, plus he had CT contrast last night. Should we start a sliding scale protocol on him or is there another suggestion?"

I think I'm getting it all in there.

I think SBAR is a good tool but like others, I always ask "are you familiar with this patient?" If the answer is yes, I skip over anything not immediately relevant to my call. If the answer is no, I use SBAR to make sure I cover everything and also to give my content a bit of structure.

I'm sure we've all gotten report that jumps all over the place and has you wondering what happened when! I know how it makes me feel at the start of a shift and can only imagine how confusing it sounds after being pulled from sleep at 3am.

We use SBAR-Q format at my hospital (Q stands for "Questions").

When I make any phone call to a doc, I start with "I have Joe Blow in ICU (room x). He's doing xxxxx (situation). He came in with xxxxx and sequelae xxxxx (background). I've noticed/assessed/found/tried x/ (Assessment). I would like to know if you wanted to try xxxxx in this situation (recommendation). Do you have any questions for me? "

Short and sweet.

While SBAR is a great tool for communicating a specific issue such as a change in patient condition, it's possible to overboard with SBAR as well. Our hospital found it so useful that we started using it for everything including patient hand off's. We soon realized that SBAR was inadequate for this type of communication and we were missing the overall story. A patient's plan of care is not a single faceted issue and is better communicated using the nursing process model in a less rigid narrative format.

I think SBAR is a good tool but like others, I always ask "are you familiar with this patient?" If the answer is yes, I skip over anything not immediately relevant to my call. If the answer is no, I use SBAR to make sure I cover everything and also to give my content a bit of structure.

I'm sure we've all gotten report that jumps all over the place and has you wondering what happened when! I know how it makes me feel at the start of a shift and can only imagine how confusing it sounds after being pulled from sleep at 3am.

No "tool" should turn us into robots. We all learned assessment skills in nursing school (if we did'nt, we should not have graduated). You ARE able to think on your feet, and the SBAR is simply a TOOL, not the God-given mandate for report, calls or anything else. The more we are "encouraged' to rely on someone else's idea of how to frame our critical thinking, the more we give over control of our practice. SBAR is a GUIDELINE, not an absolute!