Nursing Handoff Report: A Guide for Facilities

Communication among healthcare staff is essential to delivering safe, high-quality care to residents and patients. The need for a reliable nursing handoff report is vital when you consider miscommunication in healthcare has been a critical factor in:

• Nearly 80% of serious medical errors.
• Over 2,000 preventable deaths out of 7,000 malpractice claims.
• $1.7 billion in malpractice costs over five years.

As a healthcare leader committed to continuously improving the quality of care for your residents and patients, excellent communication among staff is one of your top priorities. This article will help ensure you have the knowledge needed for effective communication at your facility by reviewing the definition, function, and key components of a nursing handoff report and providing examples.

Handoff Report Definition and Function

The Joint Commission defines a handoff report as a transfer and acceptance of patient care responsibility through effective communication. During this crucial process, patient-specific information is passed from one caregiver to another in real time to ensure patient care continuity and safety.

Nurse-to-nurse handoffs serve multiple important roles, whether a patient is undergoing a procedure, getting transferred to a different unit or facility, or to sign-off at end-of-shift. Nursing report functions include the following:

• Passing responsibility and accountability for the patient’s care.
• Confirming the accuracy of information provided.
• Providing opportunities to catch and correct errors.
• Maintaining continuity of patient care.

Nursing Handoff Report Template

One of the Joint Commission’s standards requires all healthcare providers to implement a standardized approach to handoff communications and offers guidance to reduce medical errors and safeguard patients. This section will provide the Joint Commission recommendations on what to include in your handoff report and its guidelines.

Components of a Handoff Report

The Joint Commission advises healthcare organizations to incorporate the following sections into handoff reports. This is an excellent framework to build the communication tools that you can customize to best fit your facility’s needs.

1. Sender Contact Information: Provide name and call back number, especially for patient transfers off the unit or to a different facility.

Example: Nursing Handoff Report provided by Jane Barton, RN of Hillcrest Long Term Care Hospital, Pulmonary Unit, (513) 555-1212.

2. Illness Assessment: Briefly describe their current status and illness severity.

Example: Mr. Summers is stable after recovering from pneumonia and COPD exacerbation. He has poor lung reserve at baseline and wears oxygen with activity and at night.

3. Patient Summary: Describe events leading up to illness or admission, hospital course, ongoing assessment, and plan of care.

Example: Mr. Summers is a 72-year-old male, former smoker, with COPD, hypertension, and hyperlipidemia. Admitted to Lake View Hospital on 1/14 for pneumonia and COPD exacerbation, requiring intubation. He completed a 10-day course of lefamulin on 1/26 and extubated on 1/29. Transferred to HillCrest on 2/10. Mr. Summers has progressed well; he still requires oxygen but now ambulates with a walker after working with therapy. He is able to return to Silver Pine Nursing Home with outpatient follow-up with his pulmonologist, Dr. Gray.

4. Action To-Do List: Prioritize any important or time-sensitive tasks.

Example: Mr. Summers’ follow-up appointment with Dr. Gray is on 3/15 at 10 a.m.

5. Contingency Plans: Discuss the plan for any suspected risk for decompensation.

Example: Call Dr. Gray to discuss outpatient versus inpatient management if he develops any signs or symptoms of respiratory infection.

6. Code Status: List the patient’s code status.

Example: Mr. Summers is a FULL code.

7. Allergy List: Provide all allergies and their reaction.

Example: Mr. Summers is allergic to tramadol (hives).

8. Vital Signs: Provide dates and consider providing baseline values as appropriate.

Example: Today, 3/13, at 4 p.m.: temporal temperature 97.4, heart rate 80, blood pressure 130/82, respirations 16, and oxygen saturation 90% to 93%, which is also his baseline.

9. Laboratory Tests: Provide dates and consider providing baseline values as appropriate.

Example: Last lab work was on 3/11, CBC with hemoglobin of 15, he ranges low normal 14-16 at baseline, and normal WBC of 9,000.

10. Medication List: Review current medications and any planned changes upon transfer or discharge.

Example: Hydrochlorothiazide 25 mg daily by mouth (last dose 3/13 9 a.m.); Oxygen 2L NC with exertion and at night; fluticasone furoate/vilanterol (Breo Ellipta)100/25 one inhalation daily (last dose 3/13 9 a.m.); atorvastatin 40 mg once a day (last dose 3/13 9 a.m.); ipratropium bromide nebulizer: 2.5 mL (500 mcg) every six hours as needed for shortness of breath (last dose 3/09 at 7:30 p.m.).

Recommendations for Handoff Report

The Joint Commission also provides helpful guidance on the nursing handoff report and optimizing communication across all nursing departments within your facility. Healthcare leadership has a significant influence on their nurses providing excellent handoffs. Here are a few best practices to consider:

1. Standardize all communication tools and methods, including templates, forms, and checklists.
2. Require essential content to be communicated in both written and verbal form. If face-to-face communication is not feasible, use telephone or video conferencing.
3. Provide sufficient time for safe handoffs and to ask questions.
4. Communicate promptly to ensure the delivery of appropriate care.
5. Incorporate all components into one report versus communicating them separately.
6. Use mnemonics (examples below) to provide a foundation for the handoffs that will maintain consistently.
7. Conduct handoffs in a place free from interruptions and distractions.
8. As appropriate, include patients, family members, and the multidisciplinary team in handoffs.
9. Provide education, role-play scenarios with feedback, and department champions to support a culture of high-quality communication.

Examples of Nursing Handoff Report Tools

You may be curious about some communication tools available now that the review of nursing reports is complete. Here are some mnemonic-based options you may find helpful.

1. SBAR

This communication tool was previously used in the Navy and lends well to high-risk environments, such as healthcare. It is a favorite due to its ability to structure discussions to provide relevant, concise information to make quick assessments and decisions, decreasing errors and improving outcomes.

• Situation
• Background
• Assessment
• Recommendation

2. IPASS

This nursing handoff tool has reduced harm and improved communication. IPASS takes longer to implement than SBAR but lends better to the transition of care of complex patients with more in-depth communication and context.

• Illness severity
• Patient summary
• Action list
• Situational awareness/contingency planning
• Synthesis of the information by the incoming provider

3. ISHAPED

This is a standardized, patient-centered, bedside report tool for face-to-face communication between caregivers. Incorporating the patient and families in the handoff process decreases adverse events and improves awareness of the benefits of a standardized electronic handoff tool.

• Introduce
• Story
• History
• Assessment
• Plan
• Error Prevention
• Dialogue

Stay in the Know About Healthcare Operations

Now that you know what nursing handoff reports are composed of and understand the organizational benefits of a well-organized communication system, you may be looking for other ways to enhance your operations. Stay current with ways to optimize your organization through IntelyCare’s healthcare newsletter.