Acute decompensation requiring transfer: new respiratory distress with SpO₂ 84% unresponsive to the ordered O₂, RR 32, and altered mentation — SBAR to the provider, a transfer order received, the responsible party notified, and a transfer packet (orders, medications, code status, baseline, and the reason for transfer) sent with the resident; the event, communications, and serial vitals documented. On return, a Significant Change assessment is completed and the care plan revised. Skilled recognition and coordination required.
Model abnormal 2
Change of condition with a full closed loop (no transfer): new confusion, a 3-lb weight gain, and bibasilar crackles — SBAR to the provider at 09:15 with the data, an order to increase the diuretic and obtain a BMP/BNP received at 09:40, the dose administered (witnessed) and the responsible party notified at 09:45, monitoring set with a reassessment next shift; SCSA criteria evaluated (met — non-self-limiting change in two areas), an SCSA initiated, and the care plan revised.
