LAUSR

N urse handoffs are the transfer of responsibility and accountability between nurses at the beginning and end of every shift. Also called shift reports, these involve the communication of a patient’s current status, plan of care, and other critical information such as pending lab results. The goal is to promote continuity of patient care between the offgoing nurse (sender) and the oncoming nurse (receiver). In a single 30-bed hospital unit with 12-hour shifts, 60 handoffs occur each day—which translates to 21,900 handoffs per year. This frequent and complex activity presents numerous possibilities for communication failure in patient care that would have major implications on patient safety and outcomes as well as on the effectiveness, efficiency, and timeliness of care. The potential for patient harm is introduced when inaccurate, incomplete, or unnecessary information is transferred to the oncoming nurse or the receiver. Inaccurate handoff can negatively impact the continuity of care and lead to delayed or inappropriate treatment and prolonged hospital stay. Numerous barriers interfere with effective handoffs, including inadequate nurse education on effective handoffs, increased workload and time pressure among nurses, poor motivation among nurses who feel unappreciated, lack of a policy and standardized process, and the lack of leadership’s commitment to successful handoff implementation. Too much unit noise, reduced privacy, and frequent interruptions are also known to negatively impact handoffs. Successful nurse handoffs require the right preconditions, tools, and patient information delivered in the appropriate place using effective communication processes. This article takes an evidence-based approach to designing and implementing effective nurse-to-nurse handoffs.