SBAR is the gold standard communication framework in healthcare — Situation, Background, Assessment, Recommendation. When you use SBAR, you communicate like a clinician. When you don't, you communicate like a witness.
Why SBAR Exists
SBAR was developed by the U.S. Navy and adapted for healthcare to solve a specific problem: clinicians from different disciplines communicate differently, and these differences cause critical information to be missed or misunderstood. SBAR provides a common structure that ensures the receiver gets what they need, in the order they need it.
Without structure, caregivers often bury the critical finding in a narrative or start with background before the situation. SBAR puts the most critical information first and gives the nurse everything needed to make a clinical decision.
SBAR — Each Element
Situation — What is happening right now?
"I am calling about Mrs. Johnson. She has fallen and is on the floor in her bedroom. She is conscious and alert but says her right hip hurts severely." Lead with what is happening now.
Background — What is the relevant history?
"Mrs. Johnson has osteoporosis and a hip replacement on her left side three years ago. She takes a blood thinner for atrial fibrillation. She has fallen twice in the past six months." The clinical context needed to assess severity.
Assessment — What do you think is happening?
"She is unable to bear weight on the right leg and I see bruising developing at the hip. I am concerned she may have a fracture." Your clinical observation and concern — state it even if uncertain.
Recommendation — What do you need or suggest?
"I would like to call 911 — I don't think she should be moved without medical assessment." State clearly what you are asking for or what you think should happen next.
SBAR for Non-Emergency Situations
B: "He has a history of heart failure and was recently discharged. He has been eating and drinking normally. He says the swelling started two days ago."
A: "His weight is up 2 pounds from last visit. He has not had shortness of breath but says his ankle feels heavy and tight."
R: "I am concerned this could be fluid retention from his heart failure. I am wondering if you would like to assess him today or increase monitoring."
Give Your Clinical Assessment
You are not diagnosing — you are reporting what you observed and what it makes you concerned about. "I am concerned this could be..." is valuable clinical communication, not overreach. State your assessment, even when uncertain.
SBAR in Documentation
B: "History of recurrent UTIs. Last UTI 6 weeks ago. Temperature was 98.4 at last visit."
A: "Confusion not typical for baseline. Temperature elevated. Concerned for possible early infection."
R: "Reported to supervising nurse [name] at [time]. Nurse ordered urine sample collection and directed to monitor temperature and fluid intake."