ISBAR PREPARATION WORKSHEET

First & Last Name: Ajaybir kalket Institution & Program: SOT
Instructions:
• Review the available (I)SBAR scenarios and select two to use for the role play activities – select one scenario that is
specific to your current program of study and one that is not.
• Using the scenarios you’ve chosen and any readily available resources, prepare for your ISBAR communication by
completing the ISBAR sections below.
o Include two patient identifiers in the "Introduction" process. For example, say, "This report is about Bob
Henry, DOB 2/24/60."
o When speaking with ISBAR, one does not have to say, "S –situation, I am calling."
o End all communications with: "What questions do you have for me?"
• You will practice your prepared (I)SBAR Communication plans during the live session’s small group activity.
v At the completion of the session, you will be instructed to upload a copy of this completed (I)SBAR Preparation Worksheet
to your post-session survey in REDCap.
ISBAR #1
Introduction: Who you are, your role, where you are, and why you are communicating. Provide two

I
patient identifiers.
Hello Dr. Smith, this is AJ, the occupational therapist from the stroke rehabilitation unit." calling
regarding our patient, Mr. Miguel Rodriguez." DOB 08/01/1963

Situation: What is happening at the moment? Give a clear, concise overview of pertinent issues.

S
I've observed a noticeable decline in Mr. Rodriguez's condition during today's occupational therapy
session. He appeared lethargic and showed a significant decrease in motor control, particularly in his
right upper extremity.

Background:

B
Briefly state the pertinent history. What are the issues that led up to this situation?
Mr. Rodriguez, a 60-year-old man with a stroke history, is receiving occupational therapy to address
hemiparesis in his right arm and difficulties with fine motor skills. Over the last month, he has shown
steady improvement. Eager to reclaim his independence after living by himself for two decades before
his stroke, Mr. Rodriguez is deeply committed to his rehabilitation.

A
Assessment: Summarize the facts. What do you think the problem is? Use your best judgment.
Mr. Rodriguez reported feeling more tired than usual and had difficulty holding onto things. He
required assistance for tasks he had been able to perform independently last week, such as brushing
his hair and teeth with adapted grooming utensils. This is a concerning decline from his recent status.
His vitals are BP 100/70 RR -22, pulse-60

R
Recommendation: What should be done to correct this situation? What actions are you
asking for? What do you want to happen next?
Given the sudden onset of lethargy and decrease in motor control, I believe Mr. Rodriguez needs an
urgent reassessment by the medical provider to rule out any underlying issues that may be
contributing to his increased fatigue and decline in motor control. It may be important to review his
medication, check for signs of infection, or any other factors.
FOLLOW-UP ACTION: (Next Steps) "Read back " any instructions you received to the other party to ensure
accuracy. End the conversation with "what questions do you have for me?" Document the conversation in the appropriate
record.
 ISBAR #2
Introduction: Who you are, your role, where you are, and why you are communicating. Provide

I
twopatient identifiers.

Hello, this is AJ, the occupational therapist calling about our patient, Susanna Morrell." DOB
10/15/1968.

Situation: What is happening at the moment? Give a clear, concise overview of pertinent issues.

S I wanted to report a concerning regarding Ms. Morrell's recovery. She has experienced increased pain
and stiffness in her left leg during today's therapy session."

Background:

B
Briefly state the pertinent history. What are the issues that led up to this
situation?
Ms. Morrell has been in sub-acute rehabilitation facility for two weeks, following her left posterior
total hip replacement surgery. Until recently, she had been making steady progress in improving her
mobility, balance, and ADLs.

A
Assessment: Summarize the facts. What do you think the problem is? Use your best judgment.

however, Ms. Morrell reported difficulty in rising from a chair or bed and walking to the bathroom, a
significant decline in her capabilities. Upon examination, I observed mild swelling around the hip joint
and a noticeable reluctance to bear weight on her left leg.
Recommendation:

R
What should be done to correct this situation? What actions are you
asking for? What do you want to happen next?

I believe it's in best care for Ms. Morrell to be reevaluated by her orthopedic surgeon to rule out any
potential complications from the hip replacement surgery. It may also be helpful to adjust her pain
management strategy.
FOLLOW-UP ACTION: (Next Steps) "Read back " any instructions you received to the other party to ensure
accuracy. End the conversation with "what questions do you have for me?" Document the conversation in the appropriate
record.