The Art of the Shift Handover: Ensuring Safe Nursing Continuity

How to make every nurse-to-nurse handover count

A well-executed nursing handover is a cornerstone of safe patient care. Whether you are a care practitioner or an experienced ward nurse, understanding the purpose, timing, formats (such as SBAR/ISBAR), content and best practices of handover ensures continuity, reduces risk and improves outcomes. This post explains practical, NHS-aligned guidance to help you deliver clear, professional handovers every shift.

1. Purpose of Handover

The handover transfers responsibility and accountability for patients from one team to another. Its main aims are:

·Ensure continuity of care by providing up-to-date clinical information.

·Reduce risk by preventing omissions and miscommunication.

·Share priorities so incoming staff know what to monitor and which tasks are urgent.

·Enable escalation by clarifying who to contact if a patient deteriorates.

2. Timing of Handover

When and how long?

Best practice is to schedule handover during a protected shift overlap so both outgoing and incoming staff attend. Avoid starting handover late or rushing it. For complex patients, allow extra time for discussion. Important transfers between wards or services should also trigger a targeted handover even if it falls outside usual times.

3. Common Handover Formats

a) SBAR (Situation - Background - Assessment - Recommendation)

SBAR is a concise framework to structure communication:

·Situation: What is happening now?

·Background: Relevant history and context.

·Assessment: Your clinical assessment of the problem.

·Recommendation: What needs to happen next.

b) ISBAR (Introduction - Situation - Background - Assessment - Recommendation)

ISBAR adds the Introduction step, identify yourself and the recipient which is particularly useful in multidisciplinary or unfamiliar team settings to avoid ambiguity.

4. Typical Handover Content

Include the following for each patient as a routine:

·Patient identification: name, age, bed/ward, NHS/unique ID

·Current clinical status: diagnosis, recent observations, pain control

·Treatment & plans: medications, IV fluids, investigations, therapy

·Outstanding tasks: bloods, wound care, meds due, referrals

·Risks & safety: falls risk, pressure area risk, infection control

·Psychosocial & family factors: communication needs, next of kin

·Escalation plan: triggers and contacts if the patient deteriorates

5. Handover Locations

Common locations include a designated meeting room, the nurse station, or the patient bedside. Each has pros and cons:

·Meeting room: private and quiet but less patient-facing

·Nurse station / corridor: convenient but prone to interruptions

·Bedside handover: promotes patient involvement and transparency - increasingly recommended, provided confidentiality is respected

6. Handover in Different Areas

Handover content and pace should be adapted to the clinical area:

·Acute wards/ HDUs: rapid changes - focus on escalation triggers and immediate priorities

·ICU/ theatre/ recovery: multidisciplinary, highly detailed physiological data and post-op instructions

·Community/ home care: emphasis on environment, mobility, carer support and visits coordination

·Mental health: behavioural observations, leave status and safeguarding concerns

7. Best Practices

·Standardise the format: use SBAR/ISBAR to reduce omissions

·Protect the time: make handover a scheduled, interruption-free activity

·Encourage two-way communication: incoming staff must be able to ask questions and confirm understanding

·Document handover: record key points or use electronic systems for accountability

·Involve patients/carers when appropriate: bedside handover increases transparency

·Use checklists/prompts: ensure critical items (e.g., allergies, escalation plans) are never missed

·Adapt to context: tailor detail and pace to acuity and setting

·Reflect and improve: audit handovers periodically and use feedback to enhance safety

Conclusion

Mastering the nursing handover is essential for patient safety and professional practice. By focusing on clear timing, structured communication (SBAR/ISBAR), complete content, appropriate location and evidence-based best practices, you strengthen continuity of care and demonstrate nursing excellence.

References

1. NHS England - Handover guidance

2. NICE / NCBI - Structured patient handovers

3. NHS - SBAR Implementation Guide

4. PMCID - Improving patient handover (narrative review)

5. BMA - Tips for a successful handover

6. BMC Medical Education - Teaching clinical handover with ISBAR