SBAR Handoff Template

A situation, background, assessment, and recommendation handoff format for clinical communication.

Patient

SBAR handoff: 68-year-old male admitted with community-acquired pneumonia

Situation

This is Martin E., 68, in bed 412. He was admitted overnight with community-acquired pneumonia and increased work of breathing. He is now requiring 4 L oxygen by nasal cannula, up from 2 L one hour ago.

Background

History includes COPD, hypertension, and former tobacco use. He received ceftriaxone, azithromycin, and a nebulized bronchodilator in the emergency department. No known drug allergies. His daughter is at the bedside and has been updated.

Assessment

Respiratory rate is 28, heart rate 104, blood pressure 106/64, temperature 38.2 °C, and oxygen saturation 91% on 4 L. He is alert but speaking in short phrases. Right lower-lobe crackles are unchanged. Lactate is 1.8. The latest chest radiograph shows right lower-lobe consolidation.

Recommendation

Please review him at the bedside now. I recommend repeating the blood gas, continuing close oxygen monitoring, and considering a higher level of respiratory support if saturation or work of breathing worsens. I will remain available and reassess him in 30 minutes.

What this format captures

This example shows the structure clinicians use to keep the important parts of a consultation clear, complete, and easy to review.

From conversation to completed note

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