Situation–Background–Assessment-Recommendation (SBAR) in Patient Handover: A Qualitative Study of Nurses in Malaysian Private Hospitals

Abstract

Background: Patient safety and care continuity rely heavily on effective communication during handovers. While the SBAR framework is a standard global tool, there is a lack of context-specific research on its implementation within Malaysian private healthcare, particularly comparing general wards and critical care. This study addresses that gap by exploring how SBAR is utilized in these diverse clinical settings.

Methods: Using a qualitative design, semi-structured interviews were conducted with 20 purposively selected nurses (10 from general wards; 10 from critical care). Data were analysed via reflexive thematic analysis using NVivo to identify experiences and contextual influences.

Results: SBAR was found to enhance the organization, clarity, and consistency of handovers. Three key themes emerged: SBAR as a structured cognitive tool, its role in coordinating patient safety, and organizational factors influencing its use. While SBAR improved shared understanding, application was more consistent in critical care than in general wards due to differences in workload and workflow support. Barriers included initial resistance and the necessity for ongoing education.

Conclusion: SBAR is a valuable framework for structuring clinical handovers and improving team coordination in Malaysian private healthcare. However, its effectiveness is highly context-dependent, often influenced by a nurse's designation and educational level. To achieve consistent application across all ward types, hospital leadership must prioritize targeted training and integrate SBAR into routine workflows to overcome workload-related barriers and initial resistance.