Nursing handoffs are important to switch patient care from one clinician to another. But patient handoffs can also be chaotic, and chaotic handoff conditions can foster miscommunication. The Joint Commission’s Sentinel Event Data 2022 Annual Review found that when analyzing the root cause of sentinel events, communication breakdowns – such as not having a shared mental model or inadequate staff-to-staff communication – is the leading factor that contributes to sentinel events.
Interruptions can also interfere with good handoffs. Studies of nurses found that interruptions are associated with procedural failures and clinical errors. When interruptions occur during handoffs, important information can be rushed or unintentionally skipped. Interruptions may also discourage the receiver from asking clarification and follow-up questions.
Creating a quiet, standardized environment for handoffs can help reduce miscommunication for better patient care. Keep reading for tips on effective nursing handoffs.
Tips for a Better Nursing Handoff
Find a Good Location
Handoffs should be done in a quiet location with minimal distractions. When possible, do not check interruptive messages during a patient handoff. If you have to check a message and it takes more than 10 seconds, start over with the handoff for that patient.
Be Careful with Abbreviations
Abbreviations, if used, should be common and standardized. If you’re unsure whether an abbreviation is standard practice, it’s better to write it out. As a receiver, if there is any confusion about an abbreviation, ask – don’t just assume the meaning.
Standardize how you do handoffs so that both the giver and receiver have similar expectations about when and how information is shared. Have an order of how you share content, and try to follow that order during each handoff. Additionally, standardize how you share information, whether written down or shared verbally. Doing both a verbal and written handoff (written does NOT just mean on paper – technology can be great here!) is beneficial because it means the information is shared twice and helps people who learn better with auditory or visual information.
Clearly outline tasks that the next clinician needs to complete. Make sure the tasks are specific so that the next clinician knows what to do and when. Allow the receiver to ask questions about the tasks. Additionally, consider using a shared task list so that the receiver can see all their assigned tasks in one space.
Use Technology To Facilitate Handoffs
Technology can be beneficial in many aspects of the handoff. It can be used to share written information that the receiver can refer to when caring for patients. Technology can also be used to create a shared task list that assigns tasks to clinicians so they can easily see what tasks need to be done and what have been completed. Technology can enhance collaboration for smoother handoffs.
CareAlign for Nursing Handoffs
A group of nurses at Penn Presbyterian Medical Center and the University of Pennsylvania implemented a templated handoff checklist. For this case study, the checklist was implemented in CareAlign, a care team collaboration platform that works on mobile and desktop devices. The handoff provider, recipient, and independent observers evaluated the handoffs, and scores were compared before and after CareAlign’s implementation.
They found that using CareAlign for nursing handoffs improved communication at change-of-shift and the overall quality of handoffs. Nurses said CareAlign was easy to use, did not add any burden, helped improve clinical care, and was easily incorporated into the bedside report. Additionally, 91% of nurses surveyed said CareAlign will help improve the quality of patient handoffs. Learn more about the research here.