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Clinical tip - Effective handovers

Posted on 2/11/2016 by David Rennie

The nursing handover process is considered to be a crucial part of providing quality care in a healthcare environment and the quality of a report given may delay an individual nurse’s ability to provide care.

What goes in to a handover?

The overall objective of a patient handover is to ensure that patient care continues seamlessly and safely, providing the oncoming staff with pertinent information to begin work immediately. It also allows staff to maintain the ongoing confidentiality of patient records. You need to include clinical and operational information

The clinical handover of each patient is generally made up of three sections:
Past: Historical info. The patient’s diagnosis, anything the team needs to know about them and their treatment plan. So you’d include things like whether they are nil-by-mouth or require barrier nursing, if they need help with eating or using the toilet. If they are newly admitted then it’s a good idea to cover the circumstances leading to their admission.

Present: Current presentation. How the patient has been this shift and any changes to their treatment plan. Keep in mind that significant changes might have occurred before your shift that the new team are not aware of; check when they were last in and what they already know. Include physical observations and any results from assessments or investigations.

Future: What is still to be done? For lots of reasons, there can be jobs that have to be handed over to the next shift. Tasks that need to be completed at a certain time or something the team simply haven’t had time to do yet.

The operational handover should include information including: 

  • Resident numbers – Any increase or decrease in resident numbers plus a final headcount at the beginning of the shift.
  • Staffing level information - Any staff absences for the upcoming shift. Breakdown of available staff by grade.
  • Identify roles, responsibilities and tasks of staff on shift – Identify any 1-to-1 or 2-to-1 care requirements etc.
  • Updates on activities within the department / home – Is there a fire alarm due? Visits from external parties or fun activities planned for the residents.

If you’re new to a care setting ensure that you receive a complete handover from the nurse in charge. In this case, in addition to the information above you should also know:

  • Medication rounds – Has the key been handed over? What specific times are medication rounds?
  • Fire exits / evacuation – Where are the fire evacuation pints and are there any planned fire alarm tests?
  • Highlight most complex patient’s needs

Clinical tip takeaway

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