How Nurses Manage Shift Handovers: Expert Guide + Checklist

Nursing shift handovers are critical moments in patient care where information accuracy, safety, and continuity intersect. A poorly executed handover can lead to medication errors, missed interventions, and delayed responses.

In 2025, effective handovers combine structured communication frameworks, digital tools, and patient-centered approaches. This guide covers everything nurses need: evaluation strategies, best practices, tools, and checklists to streamline shift transitions.

How Do You Evaluate Nurses’ Shift Handovers?

In a survey by BMJ Quality & Safety, ICU units that implemented structured audits reduced missed interventions by 30%. Evaluating handovers ensures consistent quality and identifies areas for improvement. 

Evaluation Techniques:

• Observation & Audits: Supervisors assess clarity, completeness, and adherence to protocols.
• Staff Feedback: Surveys and interviews reveal gaps in handover practice.
• Error Monitoring: Track missed medications, delays, and adverse events.
• Time Efficiency: Ensure handovers are concise but thorough.

Metrics to Consider: completeness of patient info, communication clarity, adherence to protocol, and patient outcomes.

What Are the Most Effective Nurse Handoffs?

Structured handoffs reduce cognitive overload, improve memory retention, and lower medical error rates. 

Key components include:

1. Structured Frameworks: Use SBAR or IPASS for consistency.
2. Patient-Centered Approach: Include bedside reporting to engage patients and families.
3. Prioritized Information: Focus on high-risk or unstable patients first.
4. Interactive Communication: Encourage questions and clarifications.
5. Integrated Documentation: Written or digital records back up verbal communication  with EHR updates or mobile apps.

How to Give an Effective Nurse Handover

Follow these three phases for high-quality handovers:

1. Preparation

• Review patient charts, lab results, medications, and alerts.
• Identify high-priority patients.
• Prepare visual aids if needed.

2. Execution

• Use SBAR or IPASS templates for clarity.
• Provide verbal summaries emphasizing critical updates.
• Encourage the incoming nurse to ask questions.
• Engage patients where possible.
  

3. Follow-Up

• Document all information in the EHR or written logs.
• Confirm pending tasks and responsibilities.
• Check understanding and acknowledge completion.

Five Key Principles of Clinical Handover

Cochrane Review showed that following these principles can reduce adverse events by 25%.

1. Accuracy: Only communicate verified, up-to-date information.
2. Relevance: Focus on details critical to ongoing care.
3. Clarity: Use clear, concise language; avoid ambiguous abbreviations.
4. Timeliness: Handover must occur on schedule to prevent gaps.
5. Accountability: Ensure the receiving nurse understands and acknowledges responsibility.

Most Effective Handover Tools for Nurses

2025 handovers leverage digital and structured tools. However, technology supports handovers but cannot replace critical thinking and verbal clarification. Here are the most effective handover tools for nurses:

• EHR Systems: Centralize patient info across all shifts.
• SBAR/IPASS Templates: Guide communication and reduce omissions.
• Mobile Apps & Secure Messaging: Enable real-time updates.
• Visual Aids: Whiteboards, flow charts, and color-coded alerts.

What Does a Good Handover Plan Look Like?

According to the American Journal of Critical Care, ICU nurses using structured bedside handovers escalated deteriorating patients faster and reduced missed interventions. A good handover plan looks like: 

1. Pre-handover review: charts, labs, medications.
2. Prioritize patients: unstable first.
3. Structured communication: SBAR/IPASS.
4. Confirmation: encourage questions.
5. Documentation: record all details in EHR/log.
6. Follow-up: check pending tasks, early review of high-risk patients.

Shift Handover Checklist

To facilitate a smooth and effective handover, nurses can follow this checklist:

1. Patient Information

• Patient’s full name, age, and room number
• Primary diagnosis and any secondary conditions
• Recent changes in condition or treatment

2. Clinical Status

• Vital signs and any abnormalities
• Current medications and dosages
• Recent lab results and pending tests
  

3. Care Plan and Interventions

• Ongoing treatments and procedures
• Scheduled assessments or procedures
• Any special instructions or precautions
  

4. Patient and Family Communication

• Updates provided to the patient and family
• Any concerns or questions raised by them
• Plans for involving them in future care
  

5. Sign-Off

• Acknowledgment of received information
• Opportunity for questions and clarifications
• Confirmation of understanding and readiness

Sample Nurse Handover Using SBAR

Here’s an example of a nurse shift handover using the SBAR method:

Patient: Mr. John Smith, 68, admitted for congestive heart failure
Room: 204B
Shift: Day shift → Evening shift

S – Situation

“Mr. Smith is a 68-year-old male admitted with worsening congestive heart failure. Currently stable, but shortness of breath worsens on exertion. Oxygen saturation in room air is 92%. No chest pain at the moment.”

B – Background

“He has a history of CHF, hypertension, and Type 2 diabetes. Admitted three days ago for fluid overload. IV furosemide started on admission. Baseline weight 78 kg, current weight 82 kg. Lab results: elevated BNP (780 pg/mL), creatinine slightly increased at 1.3 mg/dL.”

A – Assessment

“Patient is alert and oriented ×3. Vitals: BP 138/82, HR 92, RR 20, Temp 36.8°C, SpO2 92% on room air. Mild peripheral edema noted in lower extremities. Lung auscultation: bibasilar crackles. IV line patent, Foley catheter draining clear urine.”

R – Recommendation

“Continue monitoring fluid balance and daily weights. Administer scheduled diuretics and medications per MAR. Monitor oxygen saturation; provide supplemental O₂ if <90%. Reassess lung sounds and edema every 4 hours. Notify physician if BP drops below 110/70, SpO₂ <90%, or patient reports increased shortness of breath.”

Why this works:

• Concise: Focuses only on critical info.
• Structured: Each SBAR section has clear, actionable content.
• Action-oriented: Includes clear recommendations for the next shift.
• Patient-focused: Highlights current condition, baseline history, and alerts.

Read more on SBAR Proper Implementation And Best Examples

Tools and Resources for Effective Shift Handover

• Digital Templates: Utilize platforms like Jotform and Template.net to access customizable handover templates.
• Training Materials: Refer to the AHRQ Nurse Bedside Shift Report Handbook for comprehensive guidelines on implementing bedside handovers.
• Educational Resources: Explore Lecturio’s Nursing Shift Report Cheat Sheet for a printable reference to standardize handover procedures.

Common Errors in Nurse Handovers

• Overloading information without prioritization.
• Skipping unstable patient updates.
• Lack of documentation or incomplete EHR entry.
• Using inconsistent terminology or abbreviations.

Check out Avoid Errors with Evidence-Based Nursing Hand-Off Communication

Tip: Highlight high-risk patients first and use structured frameworks to reduce mistakes.

Enhance Your Shift Handovers with HosTalky

Managing handovers effectively isn’t just about communication; it’s also about organization and follow-through. HosTalky offers powerful tools that make every nurse shift smoother and safer:

• Personal Notes: Keep track of critical patient updates, reminders for medications, or pending tasks.
• Reminders & Alerts: Never miss a vital action with customizable notifications for each patient or shift.
• Centralized Information: Consolidate handover notes, personal observations, and patient care instructions in one easy-to-access platform.

Reduce cognitive load and free up time to focus on patient care instead of manual tracking with HosTalky. Try it now →

Conclusion

Shift handovers are foundational to patient safety and care continuity. Combining structured frameworks, digital tools, evaluation strategies, and expert insights, nurses can create efficient, error-reducing, and patient-centered handovers.

Optimized for 2025, these methods ensure hospitals maintain high-quality care, improve staff satisfaction, and reduce clinical risks.