Accurate, thorough handovers play a vital role in any care setting. With the right information in hand, nurses, care assistants and support workers can give patients and residents the high-quality continuous care they deserve.
Handover styles vary from place to place, but their aim is always the same: to give the incoming care professional a useful snapshot of the previous shift.
In this blog, we’ll talk about what to include (and what not to include) in a handover. We’ll also hear tips from Alison Rosbrook, a registered nurse with many years of handover experience.
1. Make it concise and accurate
Handovers need to be speedy and accurate so the outgoing care professional can go home and the incoming care professional can get to work. So, it’s important to convey the most important information in a quick, concise way.
In practice, that means telling the incoming nurse, care assistant or support worker the most important information first:
- Which patients or residents are you most concerned about?
- Do any of the patients or residents have any upcoming medical tests or procedures?
- Have there been any recent medical events or emergencies on the ward or in the care home?
You don’t need to go over each resident or patient’s entire medical history because that information should be easy for the next care professional to find. However, if someone’s medical history helps provide context, it’s okay to talk about it.
“You need to tell the incoming care professional what’s important,” says Alison. “Tell them what you’ve done that day, and if there’s anyone high on the observation list.”
2. Follow a framework or checklist
Using a handover framework or checklist can help you make sure you don’t miss anything important. Most handover frameworks follow national guidelines to help multidisciplinary team members (doctors, nurses, care assistants and support workers) pass information to each other.
For example, the Royal College of Physicians (RCP) National Early Warning Score (NEWS) is a simple tool that can help you assess patients and residents based on:
- Respiratory rate
- Oxygen saturation
- Systolic blood pressure
- Pulse rate
- Level of consciousness
Assessing the people you work with based on the NEWS format can help you highlight patients and residents who need extra attention, and create a detailed, organised handover.
NEWS isn’t the only framework out there. Other structured checklists recommended by the Acute Medicine Programme include the SBAR framework, which can improve communication so people get the treatment and care they need.
SBAR stands for:
- S – situation
- B – background
- A – assessment
- R – recommendation
The SBAR tool isn’t just a handover tool – it’s useful whenever you need to communicate anything about a patient to another member of the multidisciplinary team.
3. Ask questions
If you’re the one on the receiving end of a handover, it’s important to gain a full understanding of what’s happened during the previous shift. Don’t leave it to guesswork: instead, ask questions to make sure you get all the information you need.
If you’re working in a new location, ask the outgoing nurse about policies and procedures specific to the ward or care home.
“When I arrive for a shift, my first question to the outgoing nurse is, ‘Is there anyone you’re worried about?’” says Alison. “I want to know if there’s anyone I need to keep an eye on.”
4. Take confidentiality seriously
While it’s crucial to convey information during a handover, it’s also vital to keep confidentiality in mind. In practice, this means conducting the handover somewhere quiet and out of the earshot of other patients or residents.
In some settings, handovers happen in offices or in ward reception areas. In others, outgoing and incoming care professionals walk from bedside to bedside. Whatever the case, remember to be discreet – and make sure you only discuss private, confidential information with the appropriate people.
Don’t take handover sheets home with you at the end of your shift; instead, safely destroy them with a shredder.
5. Be honest and thorough
It’s important to be honest, thorough and accountable during a handover. After all, what you say will directly impact how the incoming care professional spends their time, and who they keep an eye on.
Highlighting tasks like mouth care can help keep patients or residents more comfortable – so don’t miss the small stuff.
“A few weeks ago, I had a patient show signs of diabetic ketoacidosis,” says Alison. “During handover, I let the incoming nurse know when I’d set up the sliding scale and what the patient’s last ketone measurement was.”
Alison reiterates that it’s not usually necessary to give the incoming care professional a person’s entire medical history because it’s already written down. Instead, focus on the information your replacement might need to know straight away, so they can give patients and residents the best possible care.
A high-quality handover means high-quality care
Handovers can help you identify and talk about the care you’ve provided, so the incoming nurse, care assistant or support worker can take over seamlessly. If you give a thorough overview of which tasks you’ve done, and which still need doing, you can help make sure patients and residents stay safe and comfortable.
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