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    Sbar Rao

    Uploaded by

    iamruthann
    The document contains information about a patient including their name, age, allergies, physicians, admitting date, diagnoses, medical history, current vital signs, neurological, cardiac, pulmonary, gastrointestinal, genitourinary, skin, wounds, IV access, labs, and discharge plan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Sbar Rao

    Uploaded by

    iamruthann
    43 views1 page
    The document contains information about a patient including their name, age, allergies, physicians, admitting date, diagnoses, medical history, current vital signs, neurological, cardiac, pulmonary, gastrointestinal, genitourinary, skin, wounds, IV access, labs, and discharge plan.

    Original Description:

    SBAR Nursing Report Form

    Original Title

    SBAR RAO

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    The document contains information about a patient including their name, age, allergies, physicians, admitting date, diagnoses, medical history, current vital signs, neurological, cardiac, pulmonary, gastrointestinal, genitourinary, skin, wounds, IV access, labs, and discharge plan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    43 views1 page

    Sbar Rao

    Uploaded by

    iamruthann
    The document contains information about a patient including their name, age, allergies, physicians, admitting date, diagnoses, medical history, current vital signs, neurological, cardiac, pulmonary, gastrointestinal, genitourinary, skin, wounds, IV access, labs, and discharge plan.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Patient name Age allergies Physician

    S Room
    Room number
    number Admit date
    Admit date Attending
    Code status
    status
    Consultants
    Advanced directive on
    chart? Pgr/#
    DX
    DX

    History Isolation Core Measures


    B
    B Restraints CHF MI PNA
    CHF PNA

    Fall risk PNA Flu


    Vaccine- PNA Flu

    NEURO Activity
    Activity
    A
    A
    CARDIAC: CURRENT VITALS
    VITALS Pain/sedation

    BP/HR/Peripheral
    BP/HR/Peripheralpulses/Edema/Heart
    pulses/Edema/Heart sounds Pain scale

    Daily
    Daily wt?
    wt? RYTHM Location

    Meds type
    type and last dose
    DVT
    DVTprophylaxis
    prophylaxis

    PULMONARY: Vent/bipap etc Accu checks


    checks A1C

    Lung
    Lung sounds
    sounds settings Last Results

    GI NG/OGT Skin
    Wounds/Drainage
    BS Last BM Diet GI
    GI Prophylaxis
    Prophylaxis
    Staples
    GU Foley/void Foley
    Foley removal
    removal assessed
    assessed Drains

    Location
    Output

    IV Date inserted Psych Social

    Fluids Gtts

    Meds Pending
    Pending orders
    orders

    Na Cl
    CI Bun gluc mg BNP Coags Hct UA CT

    INR W Pl
    PI CXR
    K Co Cr Ca Phos DDimer Cultures
    PTT MRI

    Cardiac enz 1
    1 2 3 Next lab Hgb Echo

    DC Plan. Is
    Is pt
    pt informed plan___ 24 hour orders reviewed____
    informed of plan reviewed Shift goals
    R

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