Patient Endorsement/Clinical Handover/Patient Handover

Definition:
- The nursing change of shift report or handover is a communication that occurs between two shifts of
nurses whereby the specific purpose is to communicate information about patients under the care of
nurses (Lamond, 2000).
- Refers to the transfer of information from one healthcare provider to another:
- It occurs when a patient has a change of location/venue of care and/or
- When then car of responsibility for the patient shifts from one provider to another
- At the end of each shift nurses report information about their assigned clients to nurses working on
the next shift
- A handover report is usually given orally in person or during rounds at bedside
- Reports given in person or during rounds in hospital permits nurses to obtain immediate feedback when
questions are raised about patient’s/client’s care

Goals
- To improve patient care - nursing staff will be better informed so can deliver care to a higher standard
- To provide continuity of care among nurses who are caring for a client
- To encourage a more consistent exchange of information
- To increase the efficiency of handover
- At the end of a long day of caring for patients. It’s time to give the end-of-shift-report to the oncoming
nurses. Although it may be tempting to rush through this routine duty, patient safety hinges on a
complete and correct exchange of information
- An organized report follows a logical sequence to prepare for the report, the nurse gathers information
from worksheets, clients’ record and the clients care plan.

5 key principles of clinical handover (Handover requires…)

1. Preparation
2. Well-organized
3. Should provide environmental awareness
4. Must include: transfer of accountability and responsibility, handover tools
5. Giving handover

Types of Endorsement/Clinical Handover

1. Situation - at shift change; pts are transferred within and between hospital/s; admission, referral or
discharge
2. Method - face-to-face; by telephone; aided by electronic handover tools
3. Venue - at the patient’s bedside; in a common staff area; at a hospital reception or clinic reception

Patient’s endorsement/handover consist

1. Client’s name, age, marital status, religious preferences, physician and family contact
2. Medical diagnosis
3. Nursing diagnosis
4. Allergies
5. Medical orders: diet, medications, IV therapy, txs, diagnostic test and procedures, consultations, DNR
6. Activities permitted: functional limitations, assistance needed in activities of daily living and safety
precautions
7. Assessment: Paul Lee expressed difficulty in falling asleep last night. He had several questions about
procedure
8. Nursing diagnosis: His chief concerns are anxiety are r/t inexperience with invasive procedure
9. Teaching plan: he asks appropriate questions about surgery. Staff in the evenings explained
postoperative routines. I reinforced the information with him early in the night. He stated that he feels
less anxious that he knows more what to expect
- It should not simply be reading documented information. Instead significant information clients are
reviewed
- Ex. X in bed 4, a 60 yrs old client of Dr. _ is scheduled for angiography this morning. He had severe
angina. He was admitted last night with chest pain and dyspnea. This is his first experience with
invasive procedures. He knows he may require PTCA according to the vessel's condition.