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