Comprehensive SBAR Nurse Report Sheet Template

Comprehensive SBAR Nurse Report Sheet

Nurse's Name: [NURSE'S NAME]
Unit/Department: [UNIT/DEPARTMENT]
Shift: [SHIFT HOURS]
Date: [DATE]

Patient Information

Information	Details
Patient Name:	[PATIENT NAME]
Room No.:	[ROOM NUMBER]
Age/Sex:	[AGE/SEX]
Admission Date:	[ADMISSION DATE]
Primary Diagnosis:	[PRIMARY DIAGNOSIS]
Consulting Physician:	[CONSULTING PHYSICIAN]
Code Status:	[CODE STATUS]

S (Situation)

Current Concern/Issue:	[CURRENT CONCERN/ISSUE]
Reason for Report:	[REASON FOR REPORT]
Example:	"Reporting on patient [PATIENT NAME] due to a significant change in respiratory status, now requiring oxygen supplementation."

B (Background)

Medical History:	[MEDICAL HISTORY]
Medications:	[CURRENT MEDICATIONS]
Allergies:	[ALLERGIES]
Recent Procedures:	[RECENT PROCEDURES]
Example:	"Patient [PATIENT NAME] has a history of COPD, on medication including [SPECIFIC MEDICATIONS], recently underwent [SPECIFIC PROCEDURE]."

A (Assessment)

Latest Vital Signs:	BP [BLOOD PRESSURE], HR [HEART RATE], Temp [TEMPERATURE], Resp [RESPIRATORY RATE]
Physical Assessment Findings:	[PHYSICAL ASSESSMENT FINDINGS]
Patient's Current Status:	[PATIENT'S CURRENT STATUS]
Example:	"As of the last assessment, [PATIENT NAME]'s oxygen saturation decreased to [OXYGEN SATURATION]%, indicating potential respiratory distress."

R (Recommendation)

Immediate Needs:	[IMMEDIATE NEEDS]
Suggested Interventions:	[SUGGESTED INTERVENTIONS]
Follow-Up Care:	[FOLLOW-UP CARE]
Example:	"Recommend evaluation by the respiratory therapist for [PATIENT NAME] and possible escalation of care if no improvement in respiratory status."

SBAR Templates @ Template.net