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SBAR
SBAR is a situational briefing tool that logically organizes information so it can be transferred to others in an accurate and efficient manner. SBAR fosters critical thinking and eliminates information from getting lost in translation.
S – Situation (why are you calling)
B – Background (why is the patient in the hospital)
A – Assessment (your impression of the situation)
R – Recommendation (suggestions you may have)
Initiating a Rapid Response
Rapid Response is a dedicated group of individuals that responds to emergency situations within the hospital in order to try to decrease mortality and morbidity on our patients. The Rapid Responders:
Intervene in a potential code/emergency situation
Rely on bedside nurses who are highly sensitive to signs that a patient’s condition is deteriorating, and empowered to call others to action.
Notification Criteria
Respiratory Rate >10 or <24 Wet lungs
Shortness of breath Respiratory distress
Heart rate persistently > 120 Heart rate <40
Arrhythmia – Priority 1 & 2 alarms (described in Housewide Telemetry protocol) Systolic Blood Pressure <90 mmHg
Mean Arterial Pressure (MAP) < 60 mmHg Chest Pain
Mental Status Change Anxiety/Agitation
Seizures
Urine Output <30ml/hr X 2 hours
Activation of Rapid Response
Staff indicates criteria to activate Rapid Response
Staff calls “3333” (operator) and states, “Rapid Response needed in room number ___” Operator activates code pagers with message “1111 – Patient’s room number”
Assigned Rapid Responders will report to patient room
Who are the Rapid Responders?
Registered Nurse (Critical Care Services staff nurse, Clinical Nurse Manager or Charge Nurse, Nursing Supervisor)
Respiratory Therapist Designated Intern
Roles and Responsibilities
Rapid Response Registered Nurse o Arrive with tool kit
Function as a team leader in the absence of physician
Remain at bedside until patient is stabilized or transferred to appropriate level of care
Follow up visits 4 hours after the call for all patients not transferred to the ICU/CCU or 2C/N
Document on Rapid Response documentation form Respiratory Therapist
Arrive with tool kit
Function as part of the team regarding respiratory issues
Intern
Team leader
Bedside Nurse
Obtain manual vital signs
Print labs
Glucometer at bedside
Provide current situation/medical background of patient
Remain at bedside to care for patient