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Practice & Simulation Worksheet

Printable SBAR Practice Worksheet

Designed for clinical nurse educators, hospital preceptors, and nursing faculty to conduct structured communication drills, patient escalation scenarios, and simulated provider handoff exercises.

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SBARStructured Clinical Handoff Form

SBAR Clinical Communication Practice Worksheet

Healthcare Simulation & Educational Training Module

Patient: __________________
Room/Bed: _____________
Date: _________________
Time: _________________
From: __________________
Role/Unit: _____________
To: ___________________
Urgency:
S

SITUATION (What is happening now?)

When did it begin? • Brief problem statement
Current concern / reason for calling:
Onset / Duration: ___________________________
Problem Summary: ___________________________
B

BACKGROUND (Clinical Context & History)

Admitting Dx • Meds • Allergies • Labs • Baseline
Admission Diagnosis & Date:
Allergies & Code Status:
Medications & IV Fluids:
Recent Procedures / Labs / Baseline:
A

ASSESSMENT (Findings & Clinical Interpretation)

Current Vitals • Baseline Change • Observations
BP: _____/_____
HR: _____ bpm
RR: _____ /min
SpO2: _____ %
Temp: _____ °
Pain: _____ /10
Change from baseline, physical exam findings, clinical impression:
R

RECOMMENDATION (Requested Action & Timeframe)

What is needed? • Specific orders • Questions
"I recommend / request [bedside visit / STAT labs / medication order] within [timeframe]..."
Order Read-Back & Closed-Loop ConfirmationThe Joint Commission NPSG Standard
Orders received / agreed plan:
Time: ______ | Recv: _______
Source: SBARTemplate.com • Free Healthcare Communication ToolBased on AHRQ TeamSTEPPS & IHI Framework

3 Structured Simulation Drills for Healthcare Educators

Incorporate these high-yield communication exercises into your clinical residency, orientation cohort, or undergraduate nursing SIM lab:

Drill 1: 60-Second Rapid Escalation Under Pressure

Pair learners into Nurse and On-Call Physician roles. Give the nurse 1 minute to deliver the full SBAR with a clear requested order and obtain telephone order read-back confirmation without exceeding the time limit.

Drill 2: Filtering Clinical Noise in Background

Provide a complex mock electronic health record containing 10 past chronic conditions. Have learners isolate and state only the 2-3 pertinent background factors that directly explain the acute deterioration.

Drill 3: Assertive Recommendation & CUS Pushback

Simulate an uncooperative provider who dismisses findings with "Just watch them for an hour." Coach the learner to assertively deploy the TeamSTEPPS CUS phrase: "I am uncomfortable waiting because the patient is showing signs of early sepsis."

Post-Simulation Debriefing Checklist

During simulation debriefs, evaluate learner performance using these core communication criteria:

  • Was the core reason for calling delivered within the first 15 seconds?
  • Were vital signs stated as precise numerical values rather than "vitals stable"?
  • Did the recommendation specify an explicit intervention and arrival timeframe?
  • Was closed-loop verbal order read-back completed and verified?