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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is caring for a client recovering from an ischemic stroke who develops a wet, gurgling voice and coughing while taking sips of water. The nurse contacts the healthcare provider using the SBAR (Situation, Background, Assessment, Recommendation) communication tool. Arrange the nurse's statements in the correct sequence to structure this interprofessional handoff.

  1. 1I am calling about the client in Room 402 who is experiencing new-onset coughing and a wet-sounding voice while drinking water.
  2. 2The client was admitted three days ago with a left hemispheric ischemic stroke and has been tolerating a regular diet until now.
  3. 3The client's oxygen saturation has dropped to 92% on room air, and I am concerned about potential aspiration.
  4. 4I have made the client NPO. Could you prescribe an urgent speech-language pathology (SLP) swallow evaluation?

Answer

The correct sequence follows the standard SBAR protocol: Situation, Background, Assessment, and Recommendation.
The SBAR framework is a standardized communication tool used to facilitate clear, concise, and structured information exchange between interdisciplinary team members. The correct order requires stating the Situation (current problem) first, followed by the Background (clinical context), then the Assessment (nurse's findings and impression), and finally the Recommendation (requested action, such as an SLP consult).

Step-by-Step Solution

1
Identify the Situation (S)
Select the statement describing the immediate problem: 'I am calling about the client in Room 402 who is experiencing new-onset coughing...'
The first step in interprofessional communication is to quickly identify the patient and state the immediate reason for the contact.
2
Identify the Background (B)
Select the statement providing context: 'The client was admitted three days ago with a left hemispheric ischemic stroke...'
Once the provider knows the problem, they need brief, pertinent historical data to frame their clinical judgment.
3
Identify the Assessment (A)
Select the statement with clinical findings and impression: 'The client's oxygen saturation has dropped... I am concerned about potential aspiration.'
The nurse provides objective data and shares their clinical impression of what is occurring.
4
Identify the Recommendation (R)
Select the statement requesting action: 'I have made the client NPO. Could you prescribe an urgent speech-language pathology (SLP) swallow evaluation?'
The final step is to clearly state what intervention is needed from the provider or other interdisciplinary team members.

Key Concept

SBAR Communication in Interdisciplinary Collaboration
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Topics

Collaboration with Interdisciplinary Team

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