Situation, Background, Assessment, and Recommendation (SBAR) in Nursing: A Practical Communication Guide

Clear communication is essential in nursing, especially when important information must be shared quickly and accurately. Situation, Background, Assessment, and Recommendation—commonly known as SBAR—provides a structured way to organize a conversation so the most relevant information is easier to understand.

The Agency for Healthcare Research and Quality describes SBAR as a communication framework that can help healthcare teams share information about a patient’s condition, a team member, or another issue requiring attention. It can be particularly useful during handoffs, calls to providers, changes in condition, consultations, and other focused clinical conversations.

Situation: Explain What Is Happening Now

The Situation is the immediate reason for the conversation. Begin by identifying yourself, your role or unit, and the person you are calling about according to your organization’s privacy and identification procedures. Then state the concern clearly and briefly.

Questions to consider include:

• Why am I communicating now?

• What change, concern, or need requires attention?

• What is the most important fact the other person should understand first?

A focused opening might sound like:

“I’m calling about a new change in the patient’s condition.”

Avoid beginning with an extended history before explaining why the conversation is taking place. The recipient should understand the immediate concern early in the exchange.

Background: Provide the Relevant Context

The Background supplies the information needed to understand the current situation. This may include pertinent history, recent events, relevant diagnoses, medications, test results, interventions, code status, or the person’s usual baseline—depending on the situation and your role.

The goal is not to provide every detail in the record. Include the background that helps explain the concern.

Questions to consider include:

• What happened before the current situation?

• What information is directly relevant?

• What has already been done?

• Are there recent results, treatments, or changes the recipient needs to know?

Whenever possible, review the relevant record and have important information available before initiating a non-emergency conversation. In an urgent situation, follow your organization’s emergency response procedures and communicate the most critical information without delaying necessary action.

Assessment: Share What You Have Observed

The Assessment communicates what you have observed, assessed, or identified within your role and scope of practice. This section may include focused findings, vital signs, trends, symptoms, changes from baseline, responses to interventions, or other objective information.

Questions to consider include:

• What have I observed?

• What has changed?

• What objective information supports the concern?

• How has the person responded to actions already taken?

Be specific and distinguish observations from assumptions. If you are uncertain about the cause, you can clearly state the concern and the findings without presenting an unsupported conclusion.

Recommendation or Request: Clarify What Is Needed Next

The Recommendation or Request states what you need from the recipient. Depending on the situation and your scope, this may involve requesting an evaluation, asking for clarification, proposing that a specific concern be addressed, confirming monitoring expectations, or identifying the timeframe for the next step.

Questions to consider include:

• What do I need from the recipient?

• What action or decision should be considered?

• How soon is a response needed?

• What should happen if the situation changes?

Useful phrases may include:

• “I’m requesting that the patient be evaluated.”

• “Would you like any additional information or assessment?”

• “When would you like me to update you again?”

• “To confirm, the next step is…”

The AHRQ TeamSTEPPS SBAR guidance also emphasizes repeating back recommendations or requests when appropriate to confirm accuracy.

A General SBAR Example

The following fictional example demonstrates the structure without providing patient-specific clinical direction:

Situation:
“This is Jordan, the nurse on the medical unit. I’m calling about a new change I observed in the patient.”

Background:
“The patient was previously at their documented baseline. The change began recently, and I reviewed the relevant history and current orders.”

Assessment:
“My focused assessment identified a change from the earlier findings. I have the current observations and trend information available.”

Recommendation or Request:
“I’m requesting an evaluation and clarification about the next steps. When should I provide another update, and what changes would require an immediate call?”

Actual SBAR content should always be based on the individual situation, current findings, organizational policy, and the communicator’s professional role.

When Can Nurses Use SBAR?

SBAR may be helpful during:

• Shift reports and patient handoffs

• Communication about a change in condition

• Calls or messages to another member of the healthcare team

• Transfers between units or care settings

• Rapid-response or urgent team communication

• Interdisciplinary rounds

• Requests for clarification

• Safety concerns

• Nonclinical workplace conversations that benefit from a focused structure

Facilities may adapt SBAR or use another approved communication framework. Follow the process required by your workplace or nursing program.

Common SBAR Communication Mistakes

Waiting too long to explain the concern

State the immediate situation near the beginning of the conversation.

Including every available detail

Prioritize information that is relevant to the current concern. Keep other details available in case the recipient asks for them.

Mixing observations with unsupported conclusions

Clearly communicate what you observed, what changed, and what information supports the concern.

Ending without a clear request

State what you need and clarify the expected response or next step.

Failing to confirm the plan

Repeat back key instructions or agreed-upon actions according to organizational policy, especially when accuracy is important.

A Quick SBAR Preparation Checklist

Before initiating a non-emergency SBAR conversation, ask:

• Have I identified myself and the person or issue involved?

• Can I explain the immediate situation in one or two sentences?

• Do I have the relevant background information available?

• Can I clearly describe my observations or assessment?

• Do I know what I am requesting?

• Have I clarified the timeframe?

• Am I prepared to repeat back and confirm the response?

In an emergency, do not delay required emergency action to complete a checklist.

Why Structured Communication Matters

Healthcare conversations often happen in environments with interruptions, competing priorities, and time pressure. A shared structure can help the speaker stay focused and help the recipient anticipate what information is coming next.

SBAR is most effective when it is supported by attentive listening, respectful teamwork, accurate information, closed-loop confirmation, and a workplace culture in which people can raise concerns.

Key Takeaway

Situation, Background, Assessment, and Recommendation gives nurses and other healthcare team members a practical structure for organizing important conversations:

1. Explain what is happening.

2. Provide the relevant context.

3. Share what you observed or assessed.

4. State what you need, suggest, or request next.

Practicing the structure before it is needed can make it easier to organize information during a busy or stressful situation.

Continue Learning With Nursing Resource Hub

Nursing Resource Hub provides practical education, career guidance, study support, and thoughtfully researched resources for nurses and nursing students.

Follow Nursing Resource Hub on Instagram and visit NursingResourceHub.com for new nursing resources.

Related Nursing Education Topics

Add links as these pages are published:

• Closed-Loop Communication in Nursing

• How to Give an Organized Nursing Shift Report

• Communicating a Change in Patient Condition

• Nursing Documentation Fundamentals

• Understanding the Nursing Process

Educational Disclaimer

This page is provided for general educational and informational purposes. It does not replace professional education, clinical judgment, organizational policies, emergency procedures, scope-of-practice requirements, or guidance from qualified healthcare professionals. Always follow the policies and approved communication procedures of your school, employer, and licensing jurisdiction.

References

1. Agency for Healthcare Research and Quality. Tool: SBAR. TeamSTEPPS.

2. Agency for Healthcare Research and Quality. TeamSTEPPS Video: SBAR on Inpatient Medical Unit.

3. Agency for Healthcare Research and Quality. TeamSTEPPS 3.0 Pocket Guide.