Scribd Logo
Upload

Welcome to Scribd!

  • 5 views

    Form Sbar

    Uploaded by

    Mia
    This document contains a communication form called an SBAR (Situation, Background, Assessment, Recommendation) used at a community health center. It requests information about a patient's name, age, current situation, medical history, lab results, medications, vital signs, current treatment, suspected cause of the problem, and recommendations for further action. Space is provided for the receiver of the report to give instructions. The form emphasizes clearly communicating the essential details using a standardized structure.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content

    You might also like

    Form Sbar

    Uploaded by

    Mia
    5 views1 page
    This document contains a communication form called an SBAR (Situation, Background, Assessment, Recommendation) used at a community health center. It requests information about a patient's name, age, current situation, medical history, lab results, medications, vital signs, current treatment, suspected cause of the problem, and recommendations for further action. Space is provided for the receiver of the report to give instructions. The form emphasizes clearly communicating the essential details using a standardized structure.

    Original Description:

    form penilaian SBAR

    Original Title

    FORM SBAR

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document contains a communication form called an SBAR (Situation, Background, Assessment, Recommendation) used at a community health center. It requests information about a patient's name, age, current situation, medical history, lab results, medications, vital signs, current treatment, suspected cause of the problem, and recommendations for further action. Space is provided for the receiver of the report to give instructions. The form emphasizes clearly communicating the essential details using a standardized structure.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    5 views1 page

    Form Sbar

    Uploaded by

    Mia
    This document contains a communication form called an SBAR (Situation, Background, Assessment, Recommendation) used at a community health center. It requests information about a patient's name, age, current situation, medical history, lab results, medications, vital signs, current treatment, suspected cause of the problem, and recommendations for further action. Space is provided for the receiver of the report to give instructions. The form emphasizes clearly communicating the essential details using a standardized structure.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    Tanggal : Jam :

    UOBF Puskesmas Kraton

    Lembar Komunikasi SBAR


    Pelapor (nama &jabatan): Penerima Laporan :

    S
    SITUATION Nama Pasien :............................................Umur :...........................(th/bln)
    Apa yang terjadi pada saat ini ?
    Apa problemnya, kapan
    terjadinya dan bagaimana Problem :
    parahnya

    MRS/Dirawat dengan :

    Riwayat Penyakit :

    B Informasi Klinis :
    BACKGROUND
    Informasi yang berkaitan /
    mungkin berkaitan dengan
    problemnya Lab/Pemeriksaan Penunjang lain :

    (Ringkas dan penting untuk


    menerapkan problem yang Riwayat Alergi :
    terjadi atau untuk Tanda Vital saat ini :
    menentukan tindakan Kesadaran:........................................TD......../.........mmHg
    selanjutnya)

    Nadi:............x/mnt Resp:..........x/mnt Temp:........C SpO2:........%

    Terapi saat ini :

    Problem ini menurut anda disebebkan :


    A
    Assessment

    Usulan & mohon petunjuk :


    R Pemeriksaan / tindakan lebih lanjut / konsul / rujuk
    RECOMMENDATION
    Apa yang dapat dilakukan
    untuk mengatasi problem ?
    Instruksi / Anjuran dari yang menerima laporan :

    ** Catatan : ditulis (writing down) ; dibaca kembali (read back) ; diulang kembali (repeat back) ;
    dikonfirmasi oleh pemberi order (check back)

    You might also like