The four parts of SBAR
SBAR structures urgent communication between health professionals. Situation states who is calling, about whom, and what is happening now. Background gives the relevant history and current treatment. Assessment is the nurse's analysis of the problem: what the nurse thinks is going on. Recommendation (or request) states what the nurse needs. The call gives the Situation, Background, and a Recommendation, but the nurse never says what she thinks the problem is, so the Assessment is missing.
| SBAR part | Present in the call? | Content |
|---|
| Situation | Yes, statement 1 | Bed 12, pain up from 4 to 9, left toes pale and cool |
| Background | Yes, statement 2 | Femur fracture in traction, analgesic at 01:00 |
| Assessment | Missing | No statement of what she thinks is happening |
| Recommendation | Yes, statement 3 | Come within 15 minutes |
Why the Assessment matters here
The findings are worrying: pain rising sharply despite recent analgesia, with pale, cool toes in an injured leg. These may signal neurovascular compromise such as acute compartment syndrome or arterial injury. An Assessment statement such as I am concerned about compromised circulation in the left leg, possibly compartment syndrome, tells the resident why the call is urgent and focuses the response. Without it, the listener must interpret the data alone, and the urgency may be underestimated, for example treated as simple pain.
Why the distractors are wrong
Statement 2 gives the admission history and recent treatment, which is the Background. Statement 3, the request to come within 15 minutes, is the Recommendation. Statement 1 states the reason for the call and the change happening now, which is the Situation. Only the nurse's own interpretation of the data is absent.
Watch out! Data are not an assessment. Reporting the numbers and findings belongs to the Situation; the Assessment is the nurse's conclusion about what those findings mean.
Exam takeaway
Key point! In SBAR, the Assessment is the nurse's interpretation of the problem; a call that moves from data straight to a request is missing it.