How to Write & Give an SBAR Report
A practical, clinical guide on organizing your thoughts, writing concise notes, and delivering an assertive SBAR communication during high-stakes patient handoffs and physician notifications.
1. The 60-Second Pre-Call Preparation
The most common reason clinical notifications stall is incomplete preparation. Before dialing the on-call provider or walking up to the team, take 60 seconds to review the patient's record:
Pre-Notification Checklist
Obtain a full set of vitals taken within the last 15 minutes (BP, HR, RR, SpO2, Temp, Pain score), not numbers from 4 hours ago.
Have the chart open to the active Medication Administration Record (MAR), recent lab flowsheet, and admitting history.
Verify known drug allergies and confirmed code status (Full Code vs. DNR/DNI) before picking up the phone.
Decide what specific outcome you are asking for (e.g. bedside evaluation, STAT lab, pain medication order) before dialing.
2. How to Write Each SBAR Section Concisely
Writing Situation (1-2 Sentences)
Start with your identity, patient location, and the acute trigger. State the clinical parameter that crossed normal thresholds.
Writing Background (2-3 Sentences)
Filter aggressively. Mention only what is needed to understand the acute crisis: admitting diagnosis, key comorbidities, recent surgeries, active IV lines, and baseline vital signs.
Writing Assessment (2-3 Sentences)
Provide your raw objective vital sign strip, physical examination changes, and your clinical interpretation of the trend.
Writing Recommendation (1-2 Sentences)
Never end with silence. Ask for specific interventions and a clear timeframe.
3. Delivering SBAR Over the Telephone
When calling an on-call physician, speak with a calm, deliberate cadence. Keep your delivery under 60-90 seconds to allow the provider to process the acute situation quickly.
If the provider interrupts with questions, answer directly from your pre-call notes and then seamlessly guide the conversation back to your Recommendation: "Yes, urine output was 15 mL/hr over the last 2 hours. That is why I am recommending the fluid bolus and bedside review."
4. Managing Hesitation or Disagreement: The CUS Tool
If an urgent recommendation is met with resistance (e.g. "Just wait until morning rounds"), use the AHRQ TeamSTEPPS CUS escalation signal to assertively communicate patient safety concerns:
"I am concerned that waiting until morning rounds is unsafe given this patient's dropping blood pressure."
"I am uncomfortable leaving this patient without active intervention given the trending tachycardia."
"This is a critical patient safety issue. If we cannot evaluate now, I will need to activate the Rapid Response Team."
5. The 3 Non-Negotiable Rules of Telephone Order Read-Back
Per The Joint Commission National Patient Safety Goals (NPSG.02.03.01), verbal and telephone orders carry high risk for medication dosage and phonetic errors. Always execute complete closed-loop read-back:
- Write First, Then Read: Transcribe the order onto paper or into the EHR before reading it back to the provider. Never rely on memory.
- Spell Numbers & Sound-Alikes: Pronounce and spell sound-alike medications and numbers clearly (e.g. "Morphine two milligrams, that is T-W-O milligrams IV").
- Obtain Verbal Confirmation: The provider must explicitly confirm: "That is correct."
6. Common SBAR Pitfalls to Avoid
Do not begin with historical narrative. State the critical reason for the contact in sentence one.
Only share background relevant to the acute crisis. Omit non-contributory past history.
Never report vital signs that were taken several hours ago during an acute deterioration event.
Always formulate an explicit request. Saying "So that's what's going on" leaves patient care plans ambiguous.
1. Agency for Healthcare Research and Quality (AHRQ). TeamSTEPPS 3.0: Communication Techniques for Healthcare Safety.
2. Institute for Healthcare Improvement (IHI). SBAR Communication Toolkit.
3. The Joint Commission. National Patient Safety Goals & Handoff Communications Standard.
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