Focus on the result you want before you contact the physician.
If you’re struggling with getting a speedy response from the physician when your patient experiences heart failure symptoms, a targeted SBAR may be just the remedy. This form from Mary Narayan, MSN, RN, HHCNS-BC, COS-C, with Narayan Associates in Vienna, Va. will help you to present the situation clearly and concisely so you can speed things along.
SBAR Communication about
Situation:
Background: (Review medical record, Medication Profile, last visit notes, labs, etc.)
oAdmitted to home care on (date) for (reason for home care).
oDischarged from the hospital on (date) after being treated for (reason for hospitalization).
oReports did not take diuretic/follow low-sodium diet due to forgetfulness and no caregiver.
oPatient has been hospitalized for HF 3 times in past 2 months.
Assessment: (Only report primary/abnormal/pertinent data)
• Patient’s current symptoms:
• Physical assessment:
• Analysis:
Recommendation: Examples include
• To avoid rehospitalization, should the diuretic be increased to try to resolve the problem?
Exacerbation of Heart Failure
• Would you like to double the diuretic for 3 days, which worked last time for the patient?
• Would you like to order IV push furosemide to see if we can diuresis patient at home? I can visit on a daily basis for 2-3 days to administer additional doses and assure the symptoms resolve?
• Should I follow up diuretic therapy with labs in a couple of days? Electrolytes? BUN? Creatinine?
• Could we refer to MSW to assist family to determine caregiving options related to diet and med administration needs?
• Since patient has end-stage HF and patient does not want to go back to hospital, could we have orders for a DNR and referral to palliative/hospice care?