SBAR Situation, Background, Assessment, Recommendations.
When is SBAR used -calling the healthcare provider -transferring between units/other facilities -giving report to next shift -consults
Situation 1. identify yourself, your unit and the patient 2. briefly describe the problem and your concer...
Clin Apps Exam 1 Questions and Verified Answers SBAR ✅Situation, Background, Assessment, Recommendations. When is SBAR used ✅-calling the healthcare provider -transferring between units/other facilities -giving report to next shift -consults Situation ✅1. identify yourself, your unit and the patient 2. briefly describe the problem and your concern 3. what is going on with the patient 4. give the headline - one to two sentences describing the reason for the communication. Background ✅1. Provide the patient's diagnosis or reason for admission, medical status, relevant history. 2. Have the chart available. 3. Give the clinical context - as much info as required to clearly and quickly set up for the assessment data Assessment ✅1. provide specific info on vital signs, recent labs, other quantitative or qualitative data. 2. offer a provisional diagnosis or clinical impression. 3. if offering a diagnosis is inappropriate, express your concern 4. give the problem as you see it, again using a headline describing the problem. Recommendation ✅1. explain what you need 2. be clear and specific regarding your expectations and time frame 3. read back orders 4. figure out what is needed immediately to correct the problem. Telephone Communication ✅-have chart, info, and scrap paper to write on. -identify self, unit, pt to healthcare provider -repeat orders back -write orders on chart -document call Purposes of medical records ✅-legal document -communication -data complication of the pt(assessment)
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