The nurse calls the health care provider at midnight and states, "Client X in room 212 had a colectomy yesterday and is now lethargic. The client currently has a rising pulse at 130/min and a falling systolic blood pressure at 80 mm Hg. I am concerned that the client is going into shock." With regard to the SBAR (Situation, Background, Assessment, and Recommendation/Request) communication technique, what is the most important information excluded by the nurse?

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11ecbb05_cbad_5e8a_b433_b7ea08de2a4a_MD0009_00 SBAR has been updated in some facilities to I-SBAR-R (Introduction, Situation, Background, Assessment, Recommendation/Request, and Read-back). This communication technique is a framework to provide essential information in an organized fashion. It is recommended by the Joint Commission and is especially useful when a client's condition is changing rapidly. In this case, the nurse has omitted the Recommendation/Request of SBAR when communicating with the health care provider (HCP). Examples of appropriate recommendations include asking the HCP to see the client, perform a diagnostic test, request a consultation, or prescribe IV fluid administration. (Option A) The "B" in SBAR stands for background or recent history (eg, the surgery in this case). It is unnecessary to give basic demographic information (eg, age, religion) unless the information is pertinent to the current situation. (Option B) Although temperature and trend could be communicated, the vital signs that the nurse has reported are concerning enough for the HCP to act. A fever/infection is unlikely in the first 24 hours after surgery. (Option D) The "S" is standard for situation (ie, the current change in the client). The focus of the conversation is the current change in response to a recent procedure, not the client's past medical history. Educational objective: SBAR (or I-SBAR-R [Introduction, Situation, Background, Assessment, Recommendation/Request, and Read-back]) is used to communicate pertinent information regarding changes in a client's condition in an organized fashion. The content should include the situation (why the nurse is calling), background, assessment, and a recommendation/request of the health care provider.

The Nurse Calls the Health Care Provider at Midnight and States