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SBAR Nursing Handoff with De-Identify First

Turn messy clinical notes into SBAR only after stripping identifiers. Education/practice format, not live clinical advice.

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August 24, 2026

Prompt

Act as a nursing educator. Build an SBAR handoff from notes. De-identify FIRST. You are not the nurse of record. Not clinical advice for a live patient. Distinct from the NCLEX-style SBAR item writer.

Inputs:
- Notes: [Paste]
- Unit: [Unit]
- Watch list I already know: [Allergies, isolation, if present]
- If you see real identifiers: [STOP rule]

Generate:
1. De-identify pass: list names, MRN, DOB, phone, address, unique dates, photos. Replace with initials + age only. If the paste is clearly a real chart export with identifiers, STOP and tell the user to strip and rerun. Do not continue with those values.
2. SBAR: Situation, Background, Assessment, Recommendation. Only facts in the de-identified notes. Mark NOT IN NOTES rather than invent vitals or doses.
3. Do-not-invent: meds, O2, code status if missing.
4. Watch-list: copy allergies/isolation only if present after scrub.
5. Teaching note: 3 lines on what a student often buries (O2, last pain med).
6. Refusal: no diagnosis upgrade, no new orders, no "you should give 5 mg".

Constraints:
- Education/practice only.
- No real PHI in the output.
- Distinct from SOAP organizer (that is another prompt).

Instructions

Replace every [bracket] with your details before running. Works on ChatGPT, Claude, and Gemini.

Examples

Example Input

Notes: Mara Ramirez, MRN 000111, DOB 1/2/1954, room 12, day 1 right hip, sat 88% on 2L at 0510 now 92% on 2L, pain 8 to 4 after oxycodone 5 mg PO at 0400 already on MAR, dressing dry, PT 0900, family mad about parking, HTN. This is a CLASSROOM rewrite of a fake chart. Treat identifiers as a drill: show the scrub.
Unit: ortho night to day
Watch: NKDA in the fake chart
STOP: if this were a live export I would strip first; here demonstrate scrub then SBAR.

Example Output

1. De-identify
Would have stripped: Mara Ramirez, MRN 000111, DOB 1/2/1954, room 12 as unique. Classroom drill: output uses J.R., 72, no MRN, no DOB, no room number. Parking-family detail is not clinical; drop from SBAR body or put last as noise. If this had been a live chart paste, STOP before SBAR until the user reruns without identifiers. Continuing only because Inputs labeled it a fake classroom chart and asked to show the scrub.

2. SBAR (de-identified)
S: J.R., 72, day 1 after right hip arthroplasty. Overnight sat 88% on 2 L NC at 0510, now 92% on 2 L. Pain 8 to 4 after scheduled oxycodone 5 mg PO at 0400 (on MAR).
B: HTN per notes. NKDA. NOT IN NOTES: other PMH, code status, full med list.
A: Dressing dry. Sat 92% on 2 L now. Pain 4 at last record.
R: Day RN to decide whether to call RT/provider before 0900 PT given overnight 88%. I am not giving a new order.

3. Do-not-invent
No new opioid. No FiO2 change. No code status guessed.

4. Watch
NKDA as given. Isolation: NOT IN NOTES.

5. Teaching
Do not lead with parking. Do not bury 88% sat. Do not put the whole HTN story in Situation.

6. Refusal
Not advice. No "give 5 mg now". Classroom only.

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