SBAR for shift report

Blackheartednurse · Feb 6, 2010

I just started my first RN job and I'm on orientation and the facility is teaching us to use SBAR method not just to use it during our communication with doctors but also when giving report..I actually like this method, I think it definitely makes it easier to communicate with other the nurses and doctors.

Nurseinator · Feb 7, 2010

I've used SBAR and its proabably one of the best tools I have used thus far. I use it for everything, giving report, communicating with the doc etc.

mappers · Feb 7, 2010

I thought SBAR was supposed to be for communicating with a Doc. I mean, what are you "recommending" to the oncoming shift, that they take good care of the patient? I guess there are times you recommend stuff.

Our hospital is into bedside shift reporting and I've wanted to ask if anyone else is doing this. We are to walk into the patient's room and give report in front of the patient. It is supposed to include them in the care, give them an opportunity to ask questions, etc. We can even booth look at skin together etc. Most of us HATE it. Sometimes it works well with certain patients. Sometimes there is tons of family in the room or worse...a roommates family....and we all have to wonder if anyone's heard of HIPAA. Sometimes you have those overly chatty patients and/or family members and it makes things take 5 times longer than necessary. And Sometimes at 6:45 am, the patient is asleep. And it's really hard to warn the oncoming staff that someone or their spouse is a royal PIA in front of them.

The hospital apparently has evidence that his is good practice and doesn't take up any more time than any other shift report. Maybe SBAR at the patient bedside is what should work.

midinphx, BSN · Feb 7, 2010

OUr facility tried to go SBAR. Tried. It is supposed to streamline but it really is not a useful way for us to give report. The doctors didn't tolerate it well when the nurses tried to talk to them about patient needs in SBAR.

Otessa, BSN, RN · Feb 7, 2010

I always went head to toe when reporting off and obtaining information at shift change>

N-neuro/affect/mentation/attitude

P-pulmonary-O2, RT tx, breath sounds (vent settings if on)

C-Cardiac-rhythms, blood pressure, chet pain

GI/GU-are they and how are they and how much.

Ambulation-turning, heavy lifting, integumentary problems-surgical incisions(dressing changes)

Pain-0-10, what are they getting, how often, working?

IV-fluids, SL/HL, drips?

Head to toe worked for me and hit all the pertinent areas.

I have used SBAR but I modified it to fit my head to toe :-)

Theresa

Otessa, BSN, RN · Feb 7, 2010

I thought SBAR was supposed to be for communicating with a Doc. I mean, what are you "recommending" to the oncoming shift, that they take good care of the patient? I guess there are times you recommend stuff.
Our hospital is into bedside shift reporting and I've wanted to ask if anyone else is doing this. We are to walk into the patient's room and give report in front of the patient. It is supposed to include them in the care, give them an opportunity to ask questions, etc. We can even booth look at skin together etc. Most of us HATE it. Sometimes it works well with certain patients. Sometimes there is tons of family in the room or worse...a roommates family....and we all have to wonder if anyone's heard of HIPAA. Sometimes you have those overly chatty patients and/or family members and it makes things take 5 times longer than necessary. And Sometimes at 6:45 am, the patient is asleep. And it's really hard to warn the oncoming staff that someone or their spouse is a royal PIA in front of them.
The hospital apparently has evidence that his is good practice and doesn't take up any more time than any other shift report. Maybe SBAR at the patient bedside is what should work.

I've done bedside shift report in the ICU-basically we did the shift change assessment together and verified the same neuro checks, drips, etc. before the other nurse left after their shift.

otessa

vanlo001 · Feb 7, 2010

I've used it in a few situations and it works if you know what to include under each heading. I'm sure you all know the deal behind it. It was developed at kaiser when it was noted that doctors are more factual and direct in their reports while nurses are more verbose and descriptive. It's supposed to be a wAy to get just the facts and only the facts. It rolled out in our PICU and we have the sheets and we give report just as we used to. ((we gave a pretty detailed report)). We are now on my new unit rolling out relationship based care. If you've been in the game long enough you just roll your eyes. But SBAR:

situation. Ms jones is a 78 yo admitted with shortness of breath and diagnosed with community acquired pneumonia. Background: she lives in a nursing home and has a history of stroke 5 yrs ago with moderate deficits in speech and left sided weakness. She smoked for 20 yrs but quit in 94. Assessment: she is alert and oriented with a slight slur to her speech. Her vss, cap refil good lung sounds coorifice but unlabored on 2l via basal cannula. She takes a regular diet but hasn't been eating or drinking much for last 2 days. She has a20 gauge PIV with D51/2ns at 100ml/hr. Her urine output is good and labs are on the chart. Recommendations: watch her urine output. Encourage pos. Increase o2 to jeep says greater than 90% she's to use her IS QID and out of bed as tolerated TID.

It's not bad like I said you just must conn through the chart and know your patient so you can pass on relevant info.

HamsterRN, ADN, RN · Mar 18, 2010

SBAR is a useful tool for communicating a single issue, but it is not appropriate for communicating an overall patient story and plan of care. We already have a framework for organizing this information which is called the nursing process. They are similar, but at it's core SBAR is singular in focus, while a scientific process such as the nursing process provides a framework to deal with multi-faceted issues such as overall patient care. Examples of the successful use of SBAR for patient hand off tend to be better described as re-arranged nursing processes rather than SBAR.

I'm a little confused as to how some hospitals are using faxed reports with no phone call prior to transfer. Maybe it is just my state's nursing practice act, but I believe most if not all nursing practice acts require that the receiving nurse "accept" the patient prior to transfer of care, otherwise it is considered patient abandonment. This is to ensure the safety of the patient by confirming that the patient is appropriate for the scope of practice of the unit, the nurse, and is safe for the nurse's patient load.

The Joint Commission also requires that the receiving nurse always have the opportunity to ask questions.

In general, I'm skeptical that a form, particularly if it is a checkbox and fill-in-the-blank type form, can adequately capture the type of assessment and evaluation of data that is expected of a Registered Nurse.

annest · Mar 23, 2010

i would love to hear what nurses think about handoffs for my dissertation research on the patient handoff. if you have about 10 minutes to spare, can you take my survey?

if you are a nurse who has participated in shift change reports (patient handoffs), i need your help! please take a few minutes to answer some questions about the best or the worst handoff that you can remember.

what you and other nurses say are important characteristics of a shift report is the focus of my doctoral dissertation research in communication. please help by linking to this site for more information:

http://comm.uky.edu/streeter/survey

yoyomama · May 7, 2010

We are just getting started....I have revised our Kardex in SBAR format and I think it flows well with all the pertinent information... ...Just waiting for nursing feedback... , and I am currently working on all other forms as well. Anyone have a good physician call form?