Problem

Reporting Students have problems giving a succinct,

meaningful report.

Too many aeh, mhh, and scattered data

Literature supports that nurses giving unstructured report create communication problems

Conclusion:

• Communication is key to continuity and quality of care

• Students report is often scattered and choppy

• Reports by students need improvement.

Solution

S B A R

A method of report used by the NAVY

SBAR

• S= Situation• B=Background• A- Assessment• R= Recommendation

S----Situation

• Calling the M.D.

“My name is Junie B. Jones. I am a student nurse with Central Texas College. I am calling from Metroplex Hospital regarding Ms. Kelly in R. 208. There may be a problem with her discharge”

Or• Nurse-to-Nurse report

“I am the student nurse who took care of Ms. Kelly today and I would like to give you end-of-shift report”.

Situation

• This part of the report aims to orient the person who is receiving report to the situation. It’s like a picture frame.

B---Background• “Ms. Kelly is a 74 year old white female

who came here yesterday through the ER. Admitting Dx was infected diabetic ulcer left foot. She is a insulin dependent diabetic, and has a hx of CHF and COPD”.

Filling the frame with a background color

Assessment

• “Her vital signs are within normal limits. Her lungs are clear. Pitting edema to both feet and ankles is unchanged from yesterday, +1. No weight gain since yesterday. Her Fasting BS was 260 but dropped to 120 before lunch. She states that her FBS’s have been between 200 and 300 for the last 5 days. We called Dr. X but she didn’t want Ms. Kelly do be put on sliding scale. We’ll continue to check the FBS four times a day and notify the MD if > 300”.

Assessment

• “Her wound is a 4x 5x 3 cm to the medial aspect of the left foot. Wound bed is 90% covered with grey-yellow slough and 10% beefy-red. The edges are thickened and rolled under. The surrounding tissue is swollen and red in a 15 cm area all the way around the edges. We are irrigating with NSS, then covering with wet-to-dry gauze and securing with Kerlix three times a day. She tolerates the dressing changes well. Since yesterday the redness has decreased. Also, there is no foul odor to the drainage anymore. She is on Keflex 400 mg IV three times a day”.

Painting a picture of the client

Filling in the assessment with other/ e.g. environmental aspects

• “She lives by herself and is financially very limited. She states that sometimes she doesn’t have enough money to buy all her meds and thus has not been compliant with all her meds. Also, diet is an issue; she does not know how to calculate a 1800 ADA diet. She drinks 3-4 regular cokes a day”.

R-Recommendations/Questions/Concerns

• “We notified the dietician but he hasn’t called back yet. He ought to come as soon as possible because Dr. X is planning on discharging Ms. Kelly tomorrow. Also, please call the social worker. Maybe Ms. Kelly would be eligible for medication assistance. When Dr. X comes to see her ask him what she thinks about home care for a while”.

Or—if the MD is on the phone

• “We are waiting for the dietician to see her and for the social worker also. There seem to be some financial problems with affording medications and knowledge deficit regarding her diet. I was wondering what you thought about ordering home care to see her for a couple of weeks to assess this client and assist her with meds and diet?”

The Goal

• Is to find some structure that students can use to give report

• SBAR is just one structure