Inpatient shift
handover protocol
Contents
1- Acronyms
2- Definition
3- Introduction
4- Importance/rationalea
5- ISBAR
6- Management
7- Direct Patient Care Handover
8- Short Break Hand Over
9- Long Break Handover
10- conclusion
Acronyms
ISBAR-identification, situation, background, assessment, recommendation
FMOH- Federal Ministry of Health
RHB - Regional Health Bureau
SMT - Senior Management Team
Definition of terms
CLINICAL HANDOVER:- Transfer of professional responsibility and
accountability for some or all aspects of care for a patient, or group of
patients, to another person / family / legal guardian or professional
group on a temporary or permanent basis
the transfer of professional responsibility &
accountability
for some or all aspects of care for a patient or
group of patients,
to another person or professional group on a
temporary or permanent basis’
ISBAR:-acronym that stands for identification-situation-background-
assesment-recommendation.it is an evidence based communication
model that the speaker by providing a frame work to organize and
convey information
NURSE:-means a registered or enrolled nurse registered by the
FMOH/RHB
SHORT BREAK:-any time aware from the patient for 10-15 minutes
–for example transferring patients from another area, picking up
patients from another area, bathroom…
LONG BREAK:-anytime away from the patient that is greater than 15
minutes –for example meal break, education sessions, patient forum…
Introduction
This is a local guideline which sits under the overarching the purpose of this
guideline is to provide nurses across the campus with a consensus based
approach to communicating handover requirements of patients in their care
The primary objective of a “hand over” is to provide accurate information
about a patient’s care, treatment and services, current condition and any
recent or anticipated changes.
Handover of clinical care is more than just the transfer of information-it is also
a transfer of professional responsibilities. Furthermore, handover of clinical
care can provide a valuable platform for communication about operational
issues that might improve the quality of care to be delivered in the subsequent
shift and offers opportunities to spot and mitigate errors. Accordingly,
hospitals (wards) should ensure that all staff has access to relevant, accurate
and up to date sources of information (written or verbal handover) during the
24 hour cycle. Equally important, jargon related to medication details should
be minimized to reduce the risk of miss understanding. Good handover requires
Why is Clinical Handover important?
Poor communication is major contributing factor in adverse events
Poor or absent clinical handover can result in:
delay in diagnosis or treatment
missed or duplicated tests
wrong treatment
medication error
What constitutes a good Handover?
Information transferred should be
• Relevant
• Accurate
• Unambiguous
• occur in a timely manner
Transferred in a standardized format (ISBAR)
I Identify Identify yourself, your role ,and your patient
S Situation State the patient diagnosis, or reasons for
admission,& current problem
B Background Patient history-clinical background or context
A assessment Current problems, observations and treatments
R recommendation Post-handover plan include REQUESTS & RISKS
what do you recommend or want the person you
called to do?
Be clear about request &time frame. Repeat to
confirm what you have heard
MANAGEMENT
The case team manager has the responsibility to supervise
handover, and to ensure the following principles are applied:
Patient care (as required) continues while handover is
occurring
The EMR documentation tool required for the handover is
available for staff
The venue ,starting times and duration of the handover are
clear
That staffs have a good understanding of their role in their
handover
Disruptions are minimized
All relevant staff must attend handover
ISBAR is adhered to as the communication tool
Feedback (both positive and negative )is given to staffs about
their participation in handover by the case team manager the
handover process are completed as required
Allocation of patients to suitable competent nurse
Direct Patient Care Handover (Inward Based, Inpatient Areas)
Handover should occur by each patient bedside ,if not
appropriate it should occur outside patient room
Occurs between the staff members that hold responsibility for
care and the staff member who will be assuming responsibility
for the care of the patient.
Hand over should be completed in the ISBAR format utilizing
the handover function in EMR
Patient identification is to be incorporate as per the patient
identification procedure
Clinical alerts need to be included e.g. Allergies, infection
control precautions
The handover must be documented in the EMR
Short Break Hand Over or Patient/Nurse Reallocation during
Shift
Occurs between the nurse responsible for the patient and the
nurse who is assuming responsibility for the patient
Comprise of a short verbal handover focusing on the greatest
risk for the patient
Long Break Handover or Patient /Nurse Reallocation during
Shift
Occurs between nurse responsible for patient and the nurse
who is assuming responsibility for the patient
Comprises of a verbal handover in ISBAR format (ISR) –
identification of patient, current situation and any risks or
recommendations for break interval
Documentation of handover and transfer of professional care
needs to be recorded in the EMR
