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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is contacting the on-call surgical provider regarding a client who developed sudden facial twitching and hand spasms following a neck surgery. Arrange the nurse's statements in the correct sequence to reflect the standard SBAR (Situation, Background, Assessment, Recommendation) interdisciplinary communication framework.

  1. 1This is the registered nurse on the surgical unit. I am calling about the client in room 302 who is exhibiting new-onset facial twitching and hand cramps.
  2. 2The client is postoperative day one following a total parathyroidectomy and has a medical history of end-stage renal disease.
  3. 3I elicited a positive Chvostek's sign upon assessment. The client's most recent serum calcium level is 6.8 mg/dL, and the current heart rate is 112 beats per minute.
  4. 4I would like to request a prescription for intravenous calcium gluconate and an order to recheck the ionized calcium level in one hour.

Answer

The correct sequence follows the SBAR format: 1) Situation (identifying caller, client, and acute problem), 2) Background (providing surgical context), 3) Assessment (sharing objective findings and labs), and 4) Recommendation (requesting specific medical prescriptions).
The SBAR framework is an evidence-based communication tool designed to standardize interprofessional collaboration and prevent critical information from being omitted during handoffs or provider escalations. It structurally requires starting with the immediate Situation, followed by relevant Background, current Assessment data, and ending with a clear Recommendation.

Step-by-Step Solution

1
Identify the 'Situation' statement.
Select the statement where the nurse identifies their role, unit, and the immediate problem (new-onset facial twitching).
The SBAR tool begins by immediately orienting the receiver to who is calling and why the call is occurring.
2
Identify the 'Background' statement.
Select the statement describing the client's postoperative status and relevant medical history.
Once the urgency is established, the provider needs concise historical context to understand the current problem.
3
Identify the 'Assessment' statement.
Select the statement containing objective clinical data, such as a positive Chvostek's sign, vital signs, and recent calcium levels.
The provider uses the nurse's real-time assessment data to validate the clinical picture before making decisions.
4
Identify the 'Recommendation' statement.
Select the statement where the nurse requests specific medical interventions (IV calcium gluconate).
The communication concludes with a clear, actionable request to address the acute situation.

Key Concept

SBAR Interdisciplinary Communication Tool
Estimated Time:1m 0s
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Topics

Collaboration with Interdisciplinary Team

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