Nurse Brain Sheets
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1NURSE BRAIN SHEET – TELEMETRY UNIT SBAR
S
Patient
name
Age
allergies
Physician
Room
number
Admit
date
Attending
Code
status
1
Dx
2
Dx
Consultants
Advanced
directive
on
C/O
Pgr/#
chart?
B
History
Isolation
Core
Measures
Restraints
CHF
MI
PNA
Surgery:
Surgeon
Fall
risk
Vaccine‐
PNA
Flu
Anesthesia
Anesthesiologist
EBL
A
Cardiac:
BP/HR/Peripheral
pulses/Edema/Heart
sounds
Pain/sedation
Pain
scale
Current
rhythm
Location
Daily
wt?
Meds
type
and
last
dose
DVT
prophylaxis
Pulmonary:
Breath
sounds/Secretions/
SpO2/UPAs/PIP/
Vent/bipap
etc
Accu
checks
A1C
Spontaneous
VT
&
VE
Frequency
settings
Last
Results
GI
NG/OGT
Skin
Wounds/Drainage
BS
Last
BM
Diet
GI
Prophylaxis
Staples
Drains
GU
Foley/void
Location
Output
Ducub
photo
on
admission
IV
Date
inserted
Psych
Social
Fluids
Gtts
Meds
Pending
orders
Na
Cl
Bun
gluc
mg
BNP
Coags
Hct
UA
CT
INR
W
Pl
CXR
K
Co
Cr
Ca
Phos
DDimer
Cultures
PTT
MRI
Next
lab
Hgb
Echo
Cardiac
enz
1
2
3
R
DC
Plan.
Is
pt
informed
of
plan___
24
hour
orders
reviewed____
Shift
goals
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