How do I write an SBAR for a deteriorating patient?
- Expert answer
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The question
My nursing simulation assignment asks me to prepare an SBAR handover for a patient whose observations are worsening.
I am unsure what information belongs in each section and how direct the recommendation should be.
Short answer
An SBAR for a deteriorating patient should state the immediate concern, relevant background, current assessment findings and a clear recommendation. It should be concise, factual and escalation-focused.
Full expert answer
Nursing lecturer
RN, MSc Advanced Clinical Practice
SBAR stands for Situation, Background, Assessment and Recommendation. It is a structured way to communicate clinical concern clearly, especially when a patient's condition is changing. In assignments, SBAR tests whether you can prioritise information and escalate safely rather than retelling the whole case.
This page is for academic simulation and assignment writing. In practice, follow local escalation policy and work within your scope of practice.
What each section should do
| Section | Purpose | Include |
|---|---|---|
| Situation | State the immediate concern | Patient, location, current problem, why you are calling |
| Background | Give relevant context | Diagnosis, recent events, key history, treatment already given |
| Assessment | Present current findings | Observations, trend, symptoms, clinical concern, early warning score if given |
| Recommendation | Say what is needed | Urgent review, escalation, prescription review, transfer, senior advice |
Mini SBAR example
Scenario: Mr K is 68, admitted with pneumonia. His respiratory rate has risen and oxygen saturation has fallen.
Situation:
"This is Student Nurse A on Ward 3. I am calling about Mr K, a 68-year-old patient admitted with pneumonia. His oxygen saturation has fallen to 88 percent on room air and his respiratory rate is 30."
Background:
"He was admitted yesterday with community-acquired pneumonia. He has COPD and type 2 diabetes. He is receiving prescribed antibiotics."
Assessment:
"He is more breathless, using accessory muscles and appears drowsier than earlier. Temperature is 38.5, heart rate 118 and blood pressure 96/58. His observations have worsened over the last hour."
Recommendation:
"Please review him urgently. I am escalating according to the ward deterioration policy and will continue monitoring observations while waiting."
Notice the tone. It is direct but not dramatic. It gives the receiver enough information to understand risk and act.
Sample university-style questions and how to answer them
| Sample question | What a strong answer should do |
|---|---|
| Prepare an SBAR handover for a patient with possible sepsis. | Lead with the immediate deterioration, include infection context, current observations and urgent review request. |
| Write an SBAR call for a post-operative patient with low blood pressure. | Include surgery, blood loss risk, current BP trend, symptoms and recommendation for prompt assessment. |
| Identify which details from a long case study belong in Situation and Background. | Separate urgent current concern from relevant history. Do not overload Situation with old information. |
| Critique a poorly written SBAR and rewrite it clearly. | Remove vague language, add objective data, include a recommendation and use concise clinical language. |
| Explain why SBAR supports patient safety. | Discuss structured escalation, reduced omissions and clearer communication under pressure. |
Common mistakes
- Starting with a long story instead of the immediate problem
- Hiding abnormal observations in the background section
- Making no recommendation
- Saying "the patient looks unwell" without objective findings
- Including irrelevant history that distracts from deterioration
- Using SBAR as an essay format rather than clinical communication
What earns higher marks
Include trend. A respiratory rate of 30 is concerning. A respiratory rate rising from 20 to 30 in an hour is even more concerning. If your case gives repeated observations, use them. If it gives an early warning score, mention it in Assessment and connect it to escalation.
Academic use note
This content is for nursing education and simulation support only. It is not clinical advice. Students should follow their university scenario, local escalation policy and academic integrity rules.
Sources and further reading
This answer explains a method for you to apply to your own work. Copying it into a submission would count as plagiarism, and it is indexed by similarity checkers.
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