DiversityNursing Blog

Nursing hand-off or shift reports are a critical component of safe patient care in all healthcare settings. Handoff reports must be comprehensive, accurate, and designed to properly communicate essential information from one Nurse to another during shift changes. Keep reading to learn more about the importance of patient handoff reports and how to improve your handoff to reduce patient harm. 

Critical Components of a High-Quality Patient Handoff Report

A high-quality patient handoff report must contain certain key elements to ensure that the incoming Nurse understands the patient and their health condition. Some critical components of a high quality patient handoff report include

• Patient demographic information includes the patient's name, age, current diagnosis, and relevant medical and surgical history.
• The patient's current condition should include vital signs, pain levels, and any changes to these values that could affect or change their care.
• The treatment plan includes current medications, treatments, upcoming tests or procedures, and laboratory work.
• Any recent changes should be included to cover treatments, new orders, or any significant events that have affected the patient's hospitalization.
• Safety concerns include allergies, fall risks, and other safety precautions like seizure or aspiration risks.
• Psychosocial information includes the patient's emotional state or disturbances, family involvement, or any social concerns.
• Pending tasks or follow-ups that need to be completed or have not been initiated.

Benefits of A Strong Patient Handoff Report

Increase Patient Safety

An accurate patient handoff report can reduce the likelihood of medication errors, missed treatments, and other critical mistakes that could risk patient safety. When delivering a patient handoff report, information must be shared clearly and effectively to reduce the risk of errors.

All nursing handoff reports should include critical information such as patient allergies, vital signs, recent test results, patient history, and current health status to ensure that all pertinent information is shared. Another layer of protection is to give patient handoff reports in front of the patient and their family so that the patient can contribute any missing information before an error can be made.

Continuity of Care

Making sure patient handoff reports include detailed information for the incoming Nurse allows for a seamless transition into the care of another healthcare provider. When information is not shared appropriately, critical components of the patient's health status become overlooked, and errors can occur.

To ensure information is transferred correctly, many healthcare settings recommend combining written documentation with verbal communication to ensure all key points are communicated clearly and to reduce patient errors.

Promote Effective Communication

Handoff reports happen frequently in healthcare, not only from shift to shift, but also if a patient is transferred to a different floor, department, or facility. Effective communication is essential to ensure all pertinent patient information is shared correctly.

Standardizing patient handoff can significantly improve communication and reduce patient harm. A standardized patient handoff is a structured method for transferring patient information and responsibility. It can dramatically reduce the risk of missed information and allow Nurses to ask questions and gain clarity on any uncertainties. Standardized Nurse handoff reports like the SBAR model (situation, background, assessment, recommendation) can help ensure all information is properly covered. 

Enhanced Patient Outcomes

Enhancing patient outcomes is one of the greatest benefits of a comprehensive patient handoff report. With complete and up-to-date information, Nurses can properly anticipate any potential issues and proactively intervene to improve patient outcomes and provide better patient care.

A good patient handoff report also allows Nurses to individualize their patient care based on the most current information provided to them so they can better accommodate each patient's needs and preferences.

As you can see, providing a high-quality patient handoff report is vital to providing safe, effective, and comprehensive patient care. An accurate and easily understood report allows for improved communication and can also help increase patient safety and improve patient outcomes.

On an average day, Nurses interact with many patients, their families and friends, and exchange information with numerous healthcare staff. It is critical to be a good communicator because medical errors will occur if providers aren't all on the same page about patients' diagnoses, treatment plans, etc.

Some effective communication skills every Nurse should possess:

VERBAL

Verbal communication is one of the most important skills in Nursing. The goal is to always speak clearly, in a professional tone, and with honesty. Be aware of your patient's level of health literacy and avoid complex medical jargon. Vocally make sure everyone on the medical staff is on the same page about any vital patient information. 

NON-VERBAL

Patient's pick up on body language and nonverbal cues just as much as verbal language. According to Indeed, some examples of nonverbal communication skills include:

• Maintaining eye contact when speaking or listening to someone
• Having a relaxed facial expression
• Smiling
• Nodding
• Keeping arms uncrossed
• Crouching when interacting with a bedridden patient
• Respecting the patient's personal space

CULTURAL AWARENESS 

Nurses care for patients from all different backgrounds and cultures. It is important to be sensitive to the needs of each individual. For example, when working with a deaf patient or someone who speaks a language you aren't fluent in, bring in a translator if necessary. Or if someone has a preferred name or pronoun, you should respect them and refer to them by what they prefer. 

WRITTEN

We understand how incredibly busy you are every minute of your shift. Transitioning patient information to the next caregiver is critical and you must be as clear and concise as possible. This includes creating and updating your patient’s medical record and whiteboard.

Try to jot down notes as soon after meeting with your patient as possible so you don't forget anything and write clearly so others don't get confused. Notebooks and charting books are great tools for every shift. You can write down any concerns or important information about patients and discuss them later on with other team members.

ACTIVE LISTENING

Active listening means you are listening to understand the other person’s experience and empathize with their situation. This requires your ultimate attention and engagement. Some active listening techniques include:

• Nodding your head, but never interrupting. 
• Leaning forward and maintaining eye contact to let the patient know you’re engaged.
• Include minimal verbal encouragement, such as “I understand,” and “go on.”
• Repeating back to them their main point or concern

COMPASSION

Compassionate communication is the ability to exchange your thoughts and ideas with someone, while being empathetic to their suffering and anxiety. Put yourself in their shoes and create a judgment free space for them.

You can demonstrate compassion by using the parroting response which is repeating back what the patient said, but be careful not to overuse this technique because it will inhibit the patient from saying more. It's also important to validate the patient's feelings with a response of understanding or sympathy. 

As you know, Nursing is challenging, but incredibly rewarding as well. Effective communication skills improves your patient’s well-being and puts you and your healthcare team on the same page

The Joint Commission defines a hand-off as a transfer and acceptance of patient care responsibility achieved through effective communication. It is a real-time process of passing patient-specific information from one caregiver to another, or from one team of caregivers to another for the purpose of ensuring the continuity and safety of the patient’s care.

Nurses typically take great pride and exert painstaking effort to meet patient needs and provide the best possible care. Unfortunately, too often, this diligence and attentiveness falters when the patient is handed off, or transitioned, to another health care provider for continuing care, treatment or services. A common problem regarding hand-offs is communication. Expectations can be out of balance between the sender of the information and the receiver. 

Please understand we know how incredibly busy you are every minute you are working. We appreciate transitioning patient information to the next caregiver is critical and that you do everything in your power to be clear and concise. These guidelines are meant to be helpful and reinforce what you most likely are already doing to keep communication transparent and smooth.

Communication in Nursing is essential to patient safety, health and well-being. As Nurses assume more complex roles and care for older and more culturally diverse populations, strong communication skills are critical.

“According to one study, effective communication reduces stress, promotes wellness and therefore improves the overall quality of life of patients. Below are some tips to help improve communication.”

BATHE (Background, Affect, Trouble, Handling, and Empathy)

Nurses and other healthcare experts have been looking for the key to a quality patient encounter that also fits within busy workflows. At the University of Virginia, researcher Claudia Allen, JD, PhD, developed the Background, Affect, Trouble, Handling, and Empathy (BATHE) method, designed to only take five minutes.

BATHE uses open-ended conversations between patients and nurses to build strong relationships that can often go beyond clinical needs. Understanding who the patient is as a person helps the nurse connect with the patient and make her feel more comfortable during a potentially tumultuous care encounter. To learn more about BATHE click here. 

Breaking Barriers for Effective Communication

Some health care organizations may still foster a culture that discourages employees from reporting negative events.  From an ethical viewpoint, patient safety takes precedence over loyalty to peers and superiors, especially when those individuals are not conforming to safety procedures.

As a step in promoting a culture of open communication, nurse professionals must display fortitude in reporting unsafe conditions and adverse events. In the modern caregiving environment, it is no longer acceptable to blindly follow instructions. Silence can lead to negative treatment outcomes, or worse – to a mortal event.

Active Listening

Active listening is an essential holistic healthcare tool. It is a non-intrusive way of sharing a patient’s thoughts and feelings. To practice active listening, follow these steps:

• Listen to what the patient is saying.
• Repeat what you heard to the patient.
• Check with the patient to ensure your reflection is correct.

The goal of active listening is to reflect the feeling or intent behind their words. You should listen to understand, not to respond. Practice active listening as one of several ways to build rapport.

If there seems to be a disconnect, reflect what has been said by paraphrasing. "What I'm hearing is…," or "Sounds like you are saying…," are great ways to reflect back. Don’t simply repeat what the speaker has said verbatim, though—you’ll sound insincere or unintelligent. Instead, express what the speaker’s words mean to you. Ask questions to clarify certain points: "What do you mean when you say..." or "Is this what you mean?"