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Communicating Effectively using SBAR

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Poor communication is cited

70-80% of medical errors

63% of sentinel events

Medical malpractice cases

Major safety violations

Patient injury/death

Loss of license

Loss of $$$$$

+ How do you prepare before calling a physician with an issue?

Preparation

• Have the patient’s chart open • Rehearse in your mind what you want to say • Think about the goal of your call • Determine the appropriate physician to call

• Run it by another nurse if you are unsure

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How can we communicate critical info more effectively?

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S B A R

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Situation

• Problem

Background

• Brief history, relevant context, what’s been going on with the patient that now has changed

Assessment

• What you think is going on

Recommendation

• What you want or what needs to be fixed

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Example: Your diaphoretic patient

Currently, the patient is diaphoretic, alert but disoriented. Blood sugar is 66

• Diabetic; admitted yesterday with hyperglycemia

• Home meds continued: Amaryl 2mg daily PO, Metformin 500 mg daily PO

• Previous assessments: • alert & oriented• vital signs stable• AM blood sugar was 128

+ Situation : Problem

• Dr. Lane, this is Kathy at Community Hospital IMCU. I am calling you about Mr. Smith. His current blood sugar is 66 and he is symptomatic.

Background: Brief history, relevant context, what’s been going on with the patient that now has changed

• He was admitted yesterday with hyperglycemia. All of his blood sugars have been over 150 until now. He is alert and I gave him a glass of orange juice. He responded to that with a blood sugar of 92.

• Assessment: What you think is going on

• He refused to eat very much. He also told me that he skips the Metformin at home because of the gi distress.

•Recommendation: What you want or what needs to be fixed

• Do you want to change his hypoglycemic dose or frequency?

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Accept the challenge to use SBAR

• It takes practice

• Stretch yourself and become a SBAR expert

+References

Greater Chicago 2013- Article: Building Collegial Nurse-Physician Relationships retrieved from: http://www.azhha.org/patient_safety/sbar.aspx

Video: “Strengthening Nurse Physician Relationships”