SBAR Handoff Report Examples for Nurses

Communication failures are the leading root cause of sentinel events in healthcare. When the Joint Commission analyzed over 4,000 sentinel events, poor communication — particularly during handoff — was identified as a contributing factor in more than 70% of cases. SBAR (Situation, Background, Assessment, Recommendation) was developed by the U.S. Navy and adapted for healthcare to solve a specific problem: clinicians from different training backgrounds communicate differently, and those differences create dangerous gaps during patient handoffs. SBAR gives every nurse and provider a shared structure that eliminates ambiguity and ensures the most critical information is transmitted clearly, in the right order, every time.

If you want to sharpen your ability to absorb and recall handoff information under pressure, check out the Shift Report game at DailyNurseGames.com — a daily memory and comprehension game built around SBAR scenarios. You receive a full verbal handoff, then answer questions from memory.

The SBAR Framework Explained

S — Situation

What is happening right now? This is the one-sentence summary of why you're communicating. It should include the patient's name, room number, and the immediate concern. Get to the point immediately — especially when calling a provider in the middle of the night.

B — Background

What is the relevant clinical context? This includes admitting diagnosis, significant medical history, current medications relevant to the situation, recent labs or imaging, and any procedures or treatments already completed. Background gives the listener the framework to understand why the situation matters.

A — Assessment

What do you think is going on? This is your clinical judgment — what you believe is causing the situation or what you're concerned about. Many nurses hesitate here, particularly newer nurses who aren't comfortable stating a clinical impression to a physician. State it anyway. A well-founded nursing assessment ("I'm concerned this patient may be going into septic shock") is exactly what the provider needs to hear. You don't need to be right — you need to communicate your concern clearly.

R — Recommendation

What do you need? This is where you make a specific ask: an order, a patient review, a consult, a medication change, a transfer to a higher level of care. Being specific about what you need prevents the conversation from ending ambiguously with "okay, keep watching him" when what you actually need is for someone to come evaluate the patient.

SBAR Example 1: Worsening Chest Pain

Scenario: Mr. James Riordan, 58-year-old male, Room 412, admitted yesterday for NSTEMI, now reporting worsening chest pain after being pain-free for 12 hours.

Situation:
"Dr. Chen, this is Nurse Marcus calling from the cardiac floor about Mr. Riordan in Room 412. He's a 58-year-old male admitted yesterday for NSTEMI who is now reporting 8/10 chest pain, worse than when he came in. He says it started about 15 minutes ago and hasn't responded to the nitroglycerin I gave 10 minutes ago."

Background:
"Mr. Riordan was admitted with an NSTEMI and started on heparin drip, aspirin, and a statin yesterday afternoon. His last troponin at 6 p.m. was 2.4 ng/mL, up from 0.8 on admission. He has a history of hypertension and type 2 diabetes. His ECG on admission showed ST depression in leads V4 through V6. I just pulled a repeat 12-lead and there are new ST elevations in V1 through V4 that were not present this morning."

Assessment:
"I'm concerned he's evolving to a STEMI. His current vitals are BP 142/88, HR 98, RR 18, SpO2 96% on 2L NC. He's diaphoretic and appears more anxious than he did an hour ago."

Recommendation:
"I'd like you to come evaluate him now. I've already notified the charge nurse and I can have the cath lab team paged if you agree this looks like a STEMI. Should I hold the heparin or continue the current rate while you're on your way?"

SBAR Example 2: Post-Op Patient with Suspected Wound Infection

Scenario: Ms. Elena Vargas, 44-year-old female, Room 218, post-op day 3 from laparoscopic appendectomy, now with fever, increasing wound tenderness, and purulent drainage at the incision site.

Situation:
"Dr. Patel, this is Nurse Keisha calling about Ms. Vargas in Room 218, post-op day 3 from her laparoscopic appendectomy. She's developed a fever of 38.9°C in the last hour and she's complaining that her incision is significantly more painful than it was this morning."

Background:
"Ms. Vargas had an uncomplicated laparoscopic appendectomy three days ago for a non-perforated appendicitis. She was afebrile and progressing well until this afternoon. She has no significant medical history, no known drug allergies, and she's been on cefazolin prophylaxis post-op per protocol, last dose given this morning. When I assessed her wound just now, the right lower quadrant port site has approximately 2 mL of cloudy yellow drainage with surrounding erythema extending about 3 cm from the incision edges. Her WBC from this morning's labs was 13.2, up from 9.8 on post-op day 1."

Assessment:
"I'm concerned she has a surgical site infection developing at the RLQ port site. The rising WBC, fever, localized erythema, and purulent drainage together are concerning. Her pain score is 6/10 at the site with light palpation."

Recommendation:
"I'd like an order to culture the wound drainage before starting any antibiotics, and I'd like you to come look at the wound. Should I also repeat a CBC and CMP? And does she need a wound care consult?"

SBAR Example 3: Acute Change in Mental Status

Scenario: Mr. Harold Chen, 79-year-old male, Room 334, admitted for hip fracture repair, found confused and agitated during evening assessment — baseline is alert and oriented x3.

Situation:
"Dr. Williams, I'm calling about Mr. Chen in Room 334, he's a 79-year-old admitted for a left hip repair two days ago. When I went in for his evening assessment he didn't recognize me, he thought he was at his office, and he's been trying to get out of bed. This is a significant change — he was completely oriented and conversational when his family visited this afternoon."

Background:
"Mr. Chen is post-op day 2 from a left hip ORIF. He has a history of hypertension, hyperlipidemia, and mild cognitive impairment at baseline per his family, but his family says he's always been oriented to person, place, and time. He's been on oxycodone 5 mg q4h PRN for pain — last dose was two hours ago. His urine output overnight was low; I'm showing about 180 mL in the last eight hours. His last BMP from this morning showed a sodium of 131, down from 138 on admission. He has a foley catheter in place that was placed intraoperatively."

Assessment:
"I'm concerned this is acute delirium, possibly related to the hyponatremia, urinary retention, opioid use, or post-op stress — or a combination. I can't rule out a neurological event, though he has no focal deficits that I can assess. His vitals are currently BP 158/94, HR 88, RR 16, SpO2 97% on room air, temp 37.1°C."

Recommendation:
"I'd like you to come evaluate him. In the meantime, should I repeat a BMP and urinalysis, hold the next oxycodone dose, and check a bladder scan for retention? And does he need a neurology consult or imaging given his age and the acute onset?"

SBAR Example 4: Abnormal Lab Values

Scenario: Ms. Priya Nair, 67-year-old female, Room 508, admitted for CHF exacerbation, now with potassium of 6.2 on afternoon labs while on spironolactone and lisinopril.

Situation:
"Dr. Rodriguez, this is Nurse Thomas calling about Ms. Nair in Room 508. Her afternoon potassium came back at 6.2 mEq/L and she's on both spironolactone and lisinopril."

Background:
"Ms. Nair is a 67-year-old admitted two days ago for CHF exacerbation. She's been on IV furosemide 80 mg BID for diuresis — we're getting good UO, about 2.5 liters negative today. Her potassium this morning was 4.8. She's also on spironolactone 25 mg daily and lisinopril 10 mg daily from her home medications that were continued on admission. Her creatinine is 1.6, up from her baseline of 1.2. She has no complaints of muscle weakness or palpitations."

Assessment:
"I'm concerned the combination of her potassium-sparing medications and the mild AKI from aggressive diuresis has driven her potassium up quickly. A potassium of 6.2 is in the critical range and I haven't gotten a 12-lead yet — I'm pulling that now."

Recommendation:
"I need an order to hold her spironolactone and lisinopril pending your review, and guidance on whether you want Kayexalate or IV calcium gluconate given depending on the ECG findings. I'll have the 12-lead ready when you call back. Do you also want me to hold the next dose of furosemide given the AKI?"

Tips for Effective Handoff Communication

Before you call

• Have the chart open and the relevant information in front of you. Putting a provider on hold while you find the chart is a preventable error source.
• Write out your SBAR before calling if you're a newer nurse or the situation is complex. It prevents you from losing your train of thought when the provider answers.
• Have a clear ask in mind before you dial. "I just wanted to let you know" is not a recommendation — it's a liability.

When you receive an incomplete report

• Ask specifically for what you need: "What was the last potassium?" is better than "Anything else I should know?"
• If the outgoing nurse doesn't know the answer, find it yourself before accepting the patient as yours.
• Bedside handoff allows you to assess the patient directly during report — if something doesn't look right, say so before the other nurse leaves the floor.

Escalating urgent concerns

• If you've called once and the situation is deteriorating, call back. Document each call with time, who you spoke to, and what was said.
• Know your institution's chain of command for escalation. If the covering provider is not responding appropriately to a patient you're genuinely worried about, the charge nurse, supervisor, or rapid response team are the next steps — in that order.
• Rapid Response Teams exist precisely for situations where bedside nurses have a clinical concern that isn't being adequately addressed. Activating RRT is not an overreaction. It's clinical judgment.

SBAR is not a script — it's a structure. With practice, it becomes the natural way you organize clinical information whether you're giving report at shift change, calling a provider, or handing off to the transport team. The nurses who communicate most effectively aren't necessarily the ones who have been at the bedside the longest. They're the ones who have practiced organizing and transmitting clinical information until it's second nature.