This is an original excerpt written by our team to show structure, depth and referencing. It is modelled on the course named above but is not a university document. Use samples as a study guide and follow your school's academic integrity policy.
Why structure matters
Calling a provider about a patient who is getting worse is one of the highest-stakes conversations a new nurse has. Without a structure, the key finding can get lost in background detail, and the call can end without a clear plan. SBAR (situation, background, assessment and recommendation) gives the call a predictable order that both people recognize.
What the evidence shows
A systematic review found eight before-and-after studies and three controlled trials of SBAR that reported patient outcomes. Of 26 outcomes measured, eight improved significantly. The authors found moderate evidence that SBAR improves patient safety, especially when it structures phone calls, but noted a lack of high-quality research (Müller et al., 2018).
One of the larger studies trained nurses on 16 hospital wards to use SBAR when calling physicians about deteriorating patients. Afterward, all four SBAR elements were documented more often before serious adverse events (from 4% to 35%), unplanned intensive care admissions rose from 13.1 to 14.8 per 1,000 admissions, and unexpected deaths fell from 0.99 to 0.34 per 1,000 admissions (De Meester et al., 2013).
An example call
The patient is illustrative. Mr. R., 72, is on day 2 after bowel surgery.
- Situation: "This is Sam, the RN on 4 West, calling about Mr. R. in room 12. His blood pressure has dropped to 88/50 and his heart rate is 118."
- Background: "He's 72 and on day 2 after a bowel resection. His blood pressure was 128/76 at 0800. He has a history of hypertension."
- Assessment: "He's pale and restless, and his urine output has been 20 mL an hour for the last 2 hours. I'm worried he's bleeding or becoming septic."
- Recommendation: "I'd like you to see him within 15 minutes. Would you like a fluid bolus, a complete blood count and a lactate now?"
The nurse then reads back any orders and confirms when the provider will arrive.
Using SBAR well
SBAR works best when the nurse prepares before calling: has the latest vital signs, medications and lab results ready, and knows what they are asking for. The recommendation matters most, because it turns a report into a plan. When the provider gives orders, a read-back closes the loop so nothing is misheard.
References
De Meester, K., Verspuy, M., Monsieurs, K. G., & Van Bogaert, P. (2013). SBAR improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192–1196. https://doi.org/10.1016/j.resuscitation.2013.03.016
Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: A systematic review. BMJ Open, 8(8), Article e022202. https://doi.org/10.1136/bmjopen-2018-022202
