Effective Handoff Communications Practices

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Efficient handoff practices can help establish a smooth shift transition.

Proper handoff is a vital part of a nurse’s job. Nursing handoff communication takes place at the end of each shift to ensure that the incoming team has a clear understanding of patients’ statuses, what treatments or procedures have been performed and what needs to happen next.

According to the Joint Commission Center for Transforming Healthcare, some 4,000 patient handoffs take place each day at teaching hospitals across the country. The Joint Commission also found that poor communication was responsible for at least 30 percent of malpractice claims in 2016.

Handoff practices are crucial to ensuring patient safety, and RN to BSN online programs are now implementing communication training into their coursework.

Examples of Effective Nursing Handoff Communication

Efficient handoff practices can help establish a smooth transition during shift changes and uphold patient care responsibility. Commonly used techniques include:

Determining the most important information.

During handoff, nurses should begin with the most critical facts for each patient, establishing what needs to be done or addressed first at the start of a shift change. According to a study in the U.S. National Library of Medicine, nurses said that understanding the whole story and making sure all details are provided upfront is important to an effective handoff. 

Communicating in person, if possible.

Face-to-face conversations are usually the most effective way to communicate with colleagues. Questions about patients are often faster and easier to resolve in person. If talking together is not possible, a detailed list or note via email or called out in the patient’s chart may suffice.

Video conferencing can also be an effective way to communicate during a shift change. Nurses also should be available to take a phone call in case any questions or issues come up. 

Streamlining handoff communication.

Nursing managers should provide thorough forms, protocols and checklists for nurses to complete before the end of their shift. At the end of a busy day juggling multiple patients, checklists can help nurses improve communication during a shift change, according to a study published in the U.S. National Library of Medicine.

The form or checklist should include pertinent patient information, including but not limited to:

  • Code status
  • Allergy list
  • Current medication names, dosages and last time administered
  • Patient summary (what happened that led to admission, plan of care)
  • Vital signs with dates
  • Lab tests with dates
  • Contingency plan
  • To-do list
  • Contact information
  • Illness summary (including severity)

Mnemonics such as I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, synthesis by receiver) and ISBAR (identification, situation, background, assessment, recommendation) are examples of different communication protocols that can help nurses record information about their patients. 

Using electronic health records.

Technology is important in handoff procedures. An electronic health records (EHR) system allows multiple nurses to access patient information simultaneously. It also lets nurses spend more time with patients than collecting data. Nurses can use EHR data to create charts, reports and other records to bolster communication between shifts. A study published in the U.S. National Library of Medicine found that using electronic health records can speed up both chart review and the handoff process.

Communicating as a team.

Having handoff discussions as a group can eliminate the need for multiple conversations during shift changes. 

Choosing a quiet environment for handoff.

Finding a location away from the noise and constant activity in a hospital allows nurses to speak and listen without interruption to ensure that information is accurately shared between shifts. A session that is quiet also offers nurses the opportunity to process the handoff information and ask any pertinent questions.

Nurse managers also play a role in handoff procedures by providing communications support, allowing enough time between shift changes and promoting implementation of new handoff strategies.

Practiced across the board, effective communication between nurses can lead to smoother shift transitions and better care for patients.

About Duquesne University’s Online Bachelor of Science in Nursing (RN-BSN) Program

Duquesne University’s RN-BSN online program has been recognized among the best in the United States. The online program can be tailored to fit a variety of backgrounds and experience, from nursing diplomas to associate degrees in nursing.

Duquesne University has been educating nurses for more than 80 years and is an expert in online education. The university introduced the first BSN program in Pennsylvania in 1937 and created the nation’s first online nursing Ph.D. program in 1997. For more information, visit Duquesne University’s online RN-BSN website.



Sentinel Event Alert – Joint Commission Center for Transforming Healthcare

Handoffs and Patient Safety: Grasping the Story and Painting a Full Picture – U.S. National Library of Medicine

Communication in Nursing Practice – U.S. National Library of Medicine

The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review – U.S. National Library of Medicine

A Standardized Shift Handover Protocol: Improving Nurses’ Safe Practice in Intensive Care Units – U.S. National Library of Medicine

Hand-off communication: The weak link in healthcare – Beckers Hospital Review