Communication
and Handoff (SBAR)

A structured framework for safe, clear, and complete nurse-to-nurse and nurse-to-provider communication.

NCLEX-RN

What Is SBAR?

SBAR is a standardized communication tool used by nurses to share critical patient information quickly and accurately. The acronym stands for Situation, Background, Assessment, Recommendation.

Why SBAR Matters

Communication failures are a leading root cause of sentinel events in hospitals. A missed lab value or an unmentioned allergy during handoff can cause serious harm.

Patient Safety

Reduces errors during transitions of care.

Efficiency

Delivers key facts in seconds, not minutes.

Clarity

Sets shared expectations between staff.

The Four Components

Situation & Background

S

Situation: State your name, unit, the patient, and the immediate concern. Example: "This is Maria, RN. I'm calling about Mr. Lee in room 412 — his blood pressure dropped to 86/50."

B

Background: Give the relevant clinical history: diagnosis, admission reason, allergies, current meds, code status, and recent changes.

Assessment & Recommendation

A

Assessment: Share your professional judgment of the problem: "I think he may be septic — his temperature is 39.2°C and he's tachycardic."

R

Recommendation: State clearly what you need. "I'd like you to come evaluate him now, and may I start a fluid bolus and draw blood cultures?"

SBAR vs. Unstructured Report

	SBAR Handoff	Unstructured
Order	Fixed, predictable	Random
Completeness	Built-in checklist	Easy to omit data
Time	Brief, focused	Often rambling
Action	Clear request	Frequently unclear

How to Apply SBAR

1

Prepare before you call. Have the chart, vitals, and meds in front of you.

2

Follow the order. Move through S → B → A → R without skipping ahead.

3

Be concise and objective. Lead with facts and measurements, not opinions alone.

4

Close with a clear ask. Make the Recommendation specific and actionable.

Example 1: Chest Pain

S

"Dr. Adams, this is Jordan on 5 West. Mrs. Patel in 503 reports new chest pain rated 7/10."

B

"She's a 68-year-old admitted for pneumonia. History of hypertension. No known cardiac history."

A

"BP 158/94, HR 102, SpO2 94%. She's diaphoretic. I'm concerned this could be cardiac."

R

"I'd like to get a stat 12-lead ECG and troponin. Can you order those and come assess?"

Example 2: Falling Output

S

"This is Sam, RN. Mr. Cruz in 210 has had urine output under 30 mL/hr for the last 3 hours."

B

"Post-op day 1 from a bowel resection. NPO with IV fluids running at 75 mL/hr."

A

"BP 98/60, HR 110. Mucous membranes dry. I think he may be hypovolemic."

R

"May I give a 500 mL normal saline bolus and recheck output? Would you like labs?"

Example 3: Shift Handoff

At shift change, SBAR is condensed for each patient so the oncoming nurse leaves with a clear mental model:

Common Mistakes

✕ Skipping the Ask

Giving an update with no clear Recommendation leaves the provider unsure what to do.

✕ Burying the Lead

Starting with long history before stating the urgent Situation delays action.

✕ Vague Data

Saying "he looks bad" instead of giving objective vitals and measurements.

SBAR Summary

Step	Key Question	Include
Situation	What's happening?	Who, where, the concern
Background	What's the context?	Diagnosis, history, meds
Assessment	What do I think?	Vitals, your judgment
Recommendation	What do I need?	Specific action request

Check Your Understanding

You'll now answer 5 questions testing how you apply the SBAR framework in real nursing scenarios. Read each scenario carefully and select the best response.

Question 1 of 5

What does the "A" in SBAR stand for?

The "A" stands for Assessment — your professional judgment of what the problem is, supported by objective data.

Question 2 of 5

A nurse says: "Mr. Lee is a 70-year-old admitted yesterday for COPD exacerbation." Which SBAR component is this?

This is Background — it provides the relevant history and reason for admission, not the immediate concern or a request.

Question 3 of 5

Which statement best represents the Recommendation step?

The Recommendation states a specific, actionable request. The other options are Assessment, Background, and Situation respectively.

Question 4 of 5

A nurse calls a provider and gives a long history before mentioning the patient's oxygen saturation dropped to 84%. What SBAR error occurred?

The nurse buried the lead — the urgent Situation (low SpO2) should be stated first so the provider can act quickly.

Question 5 of 5

Which is the best objective Assessment statement?

The best Assessment uses objective, measurable data like vital signs — not vague impressions, requests, or background history.

Key Takeaways

1

SBAR = Situation, Background, Assessment, Recommendation — always in that order.

2

Lead with the urgent concern and support your judgment with objective data.

3

Always close the loop with a clear, specific recommendation or request.

Communicationand Handoff (SBAR)

What Is SBAR?

Why SBAR Matters

The Four Components

Situation & Background

Assessment & Recommendation

SBAR vs. Unstructured Report

How to Apply SBAR

Example 1: Chest Pain

Example 2: Falling Output

Example 3: Shift Handoff

Common Mistakes

SBAR Summary

Check Your Understanding

Question 1 of 5

Question 2 of 5

Question 3 of 5

Question 4 of 5

Question 5 of 5

Key Takeaways

Communication
and Handoff (SBAR)