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# Handoff and SBAR communication

- Safe practice

SBAR puts information into four parts so that nothing important is lost when handing over a patient or calling the doctor.

Updated Nov 5, 2026

## Key points

- S = Situation: who is calling, which patient, and what is happening now.
- B = Background: diagnosis, relevant history, allergies, recent results.
- A = Assessment: what the nurse found and what they think is going on.
- R = Recommendation or request: what needs to be done, and by when.
- Every verbal order is read back aloud to confirm it and then recorded (closed-loop communication).
- Bedside handoff, with the patient, improves safety.

On this page

- The basics Key points
- What it is
- What it requires
- Components
- How it is applied (and why)
- SBAR example of a call to the doctor (made-up data)
- Common mistakes
- Memory aid

- Safety In nursing practice

- Study Test yourself

- Connections Connections

## What it is

A handoff (or hand-over) passes the information about a patient, and responsibility for their care, to someone else. It happens at shift change, on transfers between units, on arrival in recovery and at discharge. Communication failures at these moments are a frequent cause of adverse events. WHO recommends a standardised handoff, such as SBAR (Situation, Background, Assessment and Recommendation), enough time to ask questions without interruptions, and repeat-back or read-back of key information. Some institutions use the ISBARR variant, which adds an introduction at the start and repeating back orders at the end.

## What it requires

- A common format, such as SBAR, reduces confusion.
- Enough uninterrupted time to ask and answer questions.
- Repeat back and read back critical information.
- Keep the handoff to what is needed for safe care.
- Involve the patient and family, to the degree they choose.

## Components

- Current condition and recent changes.
- Medications and treatments in progress.
- Devices: lines, tubes, drains and oxygen.
- Pending items: results, procedures, consultations.
- Risks: falls, pressure injuries, allergies, isolation.
- Advance directives and the patient's wishes, if any.

## How it is applied (and why)

- Prepare first: assess the patient and review orders, notes and results — you arrive with data, not doubts.
- Introduce yourself and say where you are calling from — the listener knows who is speaking and from which unit.
- S: give the patient's name, location and the specific reason — this focuses the conversation from the first sentence.
- B: give only the relevant background, including allergies — this saves time without leaving out what is critical.
- A: share your findings and what you think is happening — this adds your clinical judgment, not just loose data.
- R: ask for something specific with a time frame, such as seeing the patient now — the call ends with a clear action.
- Read back the orders you receive and wait for confirmation — this prevents misunderstandings.
- Record the communication, the time and who was told — this leaves a record and keeps care continuous.

## SBAR example of a call to the doctor (made-up data)

| Part | Example |
| --- | --- |
| Situation | This is the nurse on the 4th floor; the patient in bed 12 has low blood pressure and has been drowsy for 20 minutes. |
| Background | Day 2 after abdominal surgery; no known allergies; the drain output rose today. |
| Assessment | BP 84/50 mmHg, HR 118 bpm, cold skin; I think he may be bleeding. |
| Recommendation | I am asking you to come and see him now. Would you like me to start anything before you arrive? |

## In nursing practice

- In a bedside handoff, the outgoing and incoming nurses check the patient, devices and risks together.
- If visitors are present or the room is not private, confidentiality is protected during the handoff.
- On transfer to another facility the handoff is more detailed and usually uses a checklist.
- At discharge, the patient and the next care provider must know the diagnosis, plan, medications and pending results.

## Common mistakes

- Calling without having assessed the patient or reviewed the record.
- Telling the whole history before saying what is happening now.
- Ending the call without a specific request.
- Accepting a verbal order without reading it back.
- Handing over in the corridor, with interruptions and without seeing the patient.
- Not recording who was told and when.

## Memory aid

SBAR: Situation, Background, Assessment, Recommendation.

## Test yourself

Think of the answer, then tap the question to see it.

## What do the letters of SBAR stand for?

Situation, Background, Assessment and Recommendation (or request).

## What do you do with a verbal order received by phone?

Read it back aloud to confirm it with the person giving it, then record it in the clinical record.

## According to WHO, what should a standardised handoff include?

A common format such as SBAR, enough time to ask questions without interruptions, repeat-back of key points and only the information needed.

## In which part of SBAR does the nurse say what they think is happening?

In A, Assessment.

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## Connections

## Related 1

- [Nursing documentation: principles, formats and legal value](https://durgical.com/en/nursing/nursing-documentation-principles-formats-and-legal-value/)

[← All of nursing](https://durgical.com/en/nursing/)

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Communication During Patient Hand-Overs (Patient Safety Solutions, vol. 1, solution 3)](https://www.who.int/docs/default-source/patient-safety/patient-safety-solutions/ps-solution3-communication-during-patient-handovers.pdf) (World Health Organization, WHO Collaborating Centre for Patient Safety Solutions, 2007); [Nursing Fundamentals (Open RN), 2.4 Communicating with Health Care Team Members](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/02%3A_Communication/2.04%3A_Communicating_with_Health_Care_Team_Members) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); [Nursing Management and Professional Concepts (Open RN), 3.2 Communication](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Management_and_Professional_Concepts_1e_(OpenRN)/03%3A_Delegation_and_Supervision/3.02%3A_Communication) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/handoff-and-sbar-communication/