SBAR
Situation, Background, Assessment,
Recommendation
 Originated in the military
 Reliable
 Consistent
 Precise
 Clear
 Focused communication
NICU SBAR (Medicines example)
Situation
 State clearly what happened i.e. wrongly prescribed, too much/little given, given too quickly/slowly, missed dose(s),
wrong interval, wrong drug etc
Background
 Patient details, condition, reason for admission, medication being taken
 Time of drug error and time error noticed
 Workload of the staff involved
 Include the number of patients in the nursery where the incident occurred and their dependency.
 Interruptions
 Any communication with senior staff?
 Outside influences
Assessment
 State how/why you think the error occurred. Include any extenuating circumstances.
 What did you do when you realised that the error had occurred?
Recommendations
 Changes that you will make in your practice to minimise the risk of this occurring again
 Possible changes made to Unit practices to minimise this risk.
Handover
 Situation – Patient Name, gestation (actual and
corrected), days on NICU and diagnosis
 Background – (History) birth circumstances and
previous journey in hospital to today
 Assessment – Use your charts! Airway, breathing,
circulation, disability (neurological), drugs, fluids,
input/output, social, safeguarding and family
 Recommendations – plans for the day, handover
previous ward round, tests/bloods due etc
Assessment cont.
 Airway – respiratory support, interventions, bradys, desats,
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positioning aids and baby position, suction
Breathing – apnoeas? WOB, Tachyponea?
circulation, Temperature, capillary refill, tone, colour
disability (neurological), seizures, irritability, consolability
Drugs – medicines – go through the chart thoroughly
Fluids – mls/kg/day – calculate it with new staff, what milk.
Ratio of introduction (newborn or transitioning)
input/output, Fluid balance, nappys, skin care
Social & family– family situation, ?mums medical history if
relevant, what support is needed? where are parents, siblings?
Visiting? What teaching needs to be done.
Safeguarding – chronology