Reference — Fundamentals

SBAR Reference

Quick-reference guide to the SBAR communication framework — Situation, Background, Assessment, Recommendation. SBAR is the standardized clinical communication structure used for provider calls, rapid response escalation, and shift-to-shift handoff.

Educational use only. Always follow your facility's communication and chain-of-command policies. This reference is for nursing education and NCLEX preparation. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

SBAR Overview

SBAR provides a shared mental model for clinical communication — a predictable structure that ensures critical information is never omitted. It is used when nurses call providers, escalate concerns, or transfer care responsibility. Communication failures are a leading contributing factor in adverse patient events; SBAR directly addresses this risk.

S — SituationB — BackgroundA — AssessmentR — Recommendation

Before calling: gather all relevant data, have the chart open, know the patient's code status, and anticipate questions the provider will ask.

Component Quick Reference

Component	Definition	Include
S Situation	Who you are, who the patient is, and what is happening right now	Your name and location Patient name, age, room The immediate concern (1–2 sentences)
B Background	Relevant clinical context needed to understand the current concern	Admitting diagnosis Relevant PMH and comorbidities Current medications (relevant) Recent vital signs / labs (baseline)
A Assessment	The nurse's current clinical findings and impression of what may be occurring	Current vital signs Current objective findings Clinical impression / concern Change from baseline
R Recommendation	What the nurse is requesting or recommending — specific and actionable	Specific action requested Interventions already initiated If uncertain: "What would you like me to do?"

Example — Provider Call (Change in Condition)

Situation:"Dr. Patel, this is Nurse Williams on 3 South. I'm calling about Ms. Torres in Room 318, a 74-year-old patient admitted yesterday for hip fracture repair. She has developed acute confusion over the past hour."

Background:"She has a history of mild cognitive impairment at baseline, hypertension, and type 2 diabetes. She is post-op day 1, on IV morphine PCA and lisinopril. Her morning vitals were stable — BP 132/78, HR 76, temp 98.8°F, O2 sat 97% on room air."

Assessment:"Currently she is disoriented to time and place, not recognizing family members, and pulling at her IV line. Temperature is now 100.6°F, BP 148/92, HR 94, O2 sat 95% on room air. I am concerned about acute delirium — possibly related to infection, pain medication, or urinary retention."

Recommendation:"I've reoriented her and applied a fall-prevention mitt on the affected arm. I'd like you to come evaluate her and consider ordering a urinalysis, CBC, metabolic panel, and a medication review. Do you want me to bladder scan for urinary retention?"

Example — Shift Handoff Report

Situation:"Mr. Lee, Room 204, is a 58-year-old admitted 2 days ago for COPD exacerbation."

Background:"PMH: COPD, HTN, GERD. Code status: full code. Allergies: sulfa. On albuterol nebs Q4H, prednisone 40 mg PO, azithromycin, and lorazepam PRN. IV access: 20G right forearm."

Assessment:"Current vitals: BP 136/82, HR 88, RR 20, T 98.6°F, O2 sat 93% on 2L NC. Breath sounds diminished at bases bilaterally with expiratory wheeze. Pain 2/10 chest tightness. Ambulating to bathroom with assist. I&O: 1,800 mL in / 1,200 mL out last shift. BMP pending from 1400 draw."

Recommendation:"Follow up on BMP results — watch potassium given prednisone and albuterol. Continue Q4H nebs. Patient anxious about discharge — family meeting scheduled for tomorrow AM at 10. He will need oxygen teaching before discharge."

NCLEX Quick Tips

SBAR order: Situation → Background → Assessment → Recommendation — memorize and apply in order
Assessment includes the nurse's clinical impression — stating "I am concerned about..." is expected, not overstepping
Always document the SBAR call: who was called, time, information given, orders received
If the provider does not respond appropriately and you remain clinically concerned: escalate through the chain of command
Telephone orders: read back the complete order before accepting and documenting

Related Resources

SBAR Communication for NursesComplete guide with framework breakdown, scenarios, and NCLEX pearls

Open →

SBAR Template ChartComponent-by-component SBAR template with examples

Open →

Documentation and Charting BasicsDocumenting SBAR communications in the medical record

Open →

Standards & sources

Fact-checked Jun 21, 2026

This page is written to align with American Nurses Association (ANA) Standards of Practice · The Joint Commission. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →