How to Give an SBAR Report as a Skilled Nursing Facility Nurse
Use the SBAR format to structure your communication: state the Situation (patient name, room, current problem), Background (relevant medical history, medications, recent changes), Assessment (vital signs, physical findings, your clinical impression), and Recommendation (what you need from the provider—orders, evaluation, transfer). 1, 2, 3
Essential Information to Have Ready Before Calling
When contacting the provider, gather these specific data points:
- Vital signs (temperature, blood pressure, heart rate, respiratory rate, oxygen saturation)
- Acute or subacute changes in functional status (new confusion, decreased mobility, falls)
- Presence of indwelling devices (urinary catheter, IV lines, feeding tubes) and condition of insertion sites (erythema, tenderness)
- Respiratory status: breathlessness, cough, or changes in chronic respiratory symptoms
- Bowel function: most recent bowel movement and character
- Urinary symptoms: frequency, urgency, dysuria, incontinence changes 1
The SBAR Structure in Practice
S - Situation (15-20 seconds)
State the immediate problem clearly:
- Patient name, age, room number
- Chief complaint or change in condition
- Why you're calling now (e.g., "Mr. Smith in room 204 has a fever of 101.8°F and increased confusion over the past 2 hours")
B - Background (30-45 seconds)
Provide relevant context:
- Pertinent medical history and diagnoses
- Current medications (especially recent changes)
- Baseline functional and cognitive status
- Recent procedures or hospitalizations
- Advance directives status 1, 2
A - Assessment (30-45 seconds)
Share your clinical findings and interpretation:
- Complete vital signs with trends
- Focused physical examination findings
- Results of any bedside assessments performed
- Your clinical impression of what's happening
- Severity and urgency of the situation 2, 3
R - Recommendation (15-30 seconds)
State what you need:
- Specific orders you're requesting (labs, imaging, medications)
- Whether you think the patient needs in-person evaluation
- Timeline for response needed
- Whether transfer to hospital should be considered 2, 3
Practical Implementation Tips
Document your SBAR communication in the medical record immediately after the call, including the provider's name, time of contact, and orders received 1. Research shows that 87.5% of nurses find SBAR useful for organizing information, though some report it initially takes extra time 3.
Use SBAR as a verbal technique, not just a written checklist. While completing an SBAR form can help organize your thoughts, the goal is structured verbal communication that enables rapid clinical decision-making 4. Studies demonstrate that 78.1% of physicians report receiving adequate information to make clinical decisions when nurses use SBAR format 4.
Focus on dialogue rather than reading from notes. Implementation studies show SBAR increases time spent on patient-specific discussion and reduces time spent transcribing information, making reports more focused and consistent 5, 6.
Common Pitfalls to Avoid
- Don't bury the lead: State the urgent problem first, not after 2 minutes of background
- Avoid vague assessments: Instead of "patient doesn't look good," say "patient is lethargic, not responding to name, with systolic BP 85"
- Don't call without vital signs: Providers cannot make decisions without objective data
- Don't forget to state what you want: The "R" is critical—be specific about your request 3, 4
Review advance directives before initiating any intervention, as this determines the appropriate level of evaluation and treatment 1. If diagnostic tests are consciously withheld, document the reasons in the medical record 1.
The SBAR method significantly improves communication quality, reduces medication errors, and enhances identification of patient needs in long-term care settings 7, 8. While initial adoption may feel time-consuming, nurses report improved confidence and efficiency with practice 3, 9.