SBAR – SHIFT REPORT

S
B
A
R

= Situation
= Background
= Assessment
= Recommendation

S
This is report for pt: _______________________age: _____ in room ______
Admitted for:__________________________________________________
B
Pertinent Hx: __________________________________________________
Allergies: _________________________________ Code Status: ________
Precautions: Fall ______ Isolation ______ Activity Level: ______________
Current Therapies: _____________________________________________
IV/PICC: _____________________________________________________
Procedures: __________________________________________________
Significant Labs: _______________________________________________
VS: BP _______ Pulse ____ Resp ____ Sat ____ Temp _____ Sugar____
PRN meds given/response: ______________________________________
Focused Physical Assessment Findings: ____________________________
Nutritional Status: _____________ Void: ____________ BM: ___________
Skin integrity: _________________________________________________
A
Psychosocial issues: ____________________________________________
Discharge Plans? _____________________________________________
R

Pt goal(s): ____________________________________________________
Suggestions/Follow-up: __________________________________________

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