NIGHTINGALE INSTITUTE OF NURSING, NOIDA

ASSIGNMENT
ON
TOPIC:HANDING & TAKING OVER REPORTS
SUBJECT: NURSING MANAGEMENT

SUBMITTED ON :

SUBMITTED TO : SUBMITTED BY :

Mrs. Thongam Kapeelta Devi Maam Ms. Roopa Kataria

Vice- Principal M. Sc. Nursing 2nd Year
(Pediatric Nursing Department) Child Health Speciality
NIN, Noida UP NIN, Noida UP
 INTRODUCTION
All professional nurses need to be accountable for the performance of their duties to the
public. Since nursing has been considered as profession, nurses need to record their work on
completion. Records are a practical and indispensable aid to the doctor, nurse and
paramedical personnel in giving the best possible service to the clients. Report summarizes
the services of the person or personnel and of the agency.

Vacuum should not be created by either transfer, resignation of any officer in both civil and
public service. There should be effective handing over process between the outgoing and the
incoming officer to ensure continuity in the public service delivery. Of course, handing over
process also applies in the private sector. Hand over notes are kept in the files as parts of
official records of an organization and are good reference materials by the serving officers in
the civil/public service on assumption of duty. When politics is allowed to take precedence
over establishment rules in matters of bureaucracy, it becomes practically impossible to have
proper handing over process. So, politicization of handing over process is a bane to efficient
management and continuity in administration.

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 the bedside .Reports given in person or during rounds in hospital permit
nurses to obtain immediate feedback when questions are raised about a patient’s/client’s
care.

REPORTS:

Reports are oral or written exchanges of information shared between caregivers or workers in
a number of ways. A report is the summary of the services of person or personnel and of the
agency.

IMPORTANCE OF REPORTS

 Good reports save duplication of effort and eliminate the need for investigation to
learn the facts in a situation.
 Full reports often save embarrassment due to ignorance of situation.
 Patients receive better care when reports are through and give all pertinent data.
 Complete reports give a sense of security which comes from knowing all factors in
the situation.
  It helps in efficient management of the ward
.
PURPOSES OF REPORTS:

 To show the kind and quantity of services rendered over to a specific period.
 To show the progress in reaching goals.
 As an aid in studying health conditions.
 As an aid in planning.
 To interpret the services to the public and to other interested agencies.

CRITERIA OF GOOD REPORT:

 Reports should be made promptly if they are to serve their purpose well.
 A good report is clear, complete concise.
 If it is written all pertinent, identifying data are include – the date and time, the people
concerned, the situation, the signature of the person making the report.
 It is clearly stated and well organized for easy understanding.
 No extraneous material is included.
 Good oral reports are clearly expressed and presented in an interesting manner.
Important points are emphasized.

TYPES OF REPORTS:

 Oral Reports – Oral reports are given when the information is for immediate use and
not for permanency. E.g. it is made by the nurse who is assigned to patient care, to
another nurse who is planning to relieve her.
 Written Reports – Reports are to be written when the information to be used by
several personnel, which is more or less of permanent value, e.g. day and night
reports, census, interdepartmental reports, needed according to situation, events and
condition.
HANDING OVER AND TAKING OVER REPORTS

DURING OUR SUMMER FIELD POSTING WE LEARNED ABOUT THE HOW

TO GIVE TAKING & HANDING OVER REPORT OF ALL PATIENT IN EACH
AND EVERY 3X SHIFT DUTIES ( 24X7)AT DHRAMSHILA SUPERSPECIALITY
CANCER HOSPITAL NEW DELHI,FROM (29/05/2023 TO 15/62023 )

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)

TARGET USERS:

All nursing and midwifery staff involved in the transfer of patient information from one
member of staff to another.

OBJECTIVES:

 To ensure that patient care continues seamlessly and safely, providing the oncoming
nurses with pertinent information to begin work immediately.
 To maintain the on-going confidentiality of patient records.
 To improve patient care - nursing staff will be better informed so can deliver care to a
higher standard.
 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 work sheets, clients’ records and the clients care plan.

GUIDELINES FOR NURSING HANDOVER FOR ADULT PATIENTS:

 The shift report may occur in some areas up to three times a day. It may vary in length
from a ‘full report’ lasting between 30 minutes up to an hour or longer to a ‘head line
report’ which may give a quick overall patient update following a particular busy part
of the day.

 Handover should not just be directed towards the nurse in charge. All nurses coming
on to a shift need a handover.
  The start of the handover is also the best opportunity for the nurse in charge to
formally hand over the controlled drug keys (if appropriate) to the oncoming person
in charge of the shift.
 A safety briefing is undertaken at the beginning of a shift handover. This should not
extend the time of handover, should last only 2-3 minutes and the focus should be the
specific patient safety issues for that clinical area on that shift. This information
should be carried forward to the next shift and should simply highlight safety as a
main priority.
 The Situation, Background, Assessment and Recommendation (SBAR) model can be
used by any health professional to communicate clinical information about a patient’s
condition.
 Use a structured approach to enable all staff to focus on handing over what is relevant,
avoiding overload and passing on irrelevant information. Information relayed should
follow the 5 P’s rule:
 P-1 Patient’s name, diagnosis, doctor and past relevant history (if this
Information is not on handover information sheet)

 P -2 Patient’s date/reason for admission and/or date post op

 P -3 Present restrictions: nil orally, fluids only, diabetic diet, non-weight
bearing etc.
 P-4 Plan of Care; The patients main problem/need is………. and will need
…….. The next problem/need is………and will need ………etc.
 P-5 what part can you play in the next shift? The handover should show
progression.

RATIONALE FOR HANDLING OVER PROCESS:

Handover notes in both civil and public service is a key cultural practice that every good
Administrator or Schedule Officer must learn how to write. It is a routine practice that when
ignored can lead to outcry or sort of organizational conflict, particularly between the officer
leaving a position/schedule and his successor.

In essence, an officer in the civil/public service leaving his current employment on the
grounds of resignation, transfer, and long leave, is required to prepare handover notes to assist
the successor to properly take over and to effectively carry out his duties. Other specific
personnel mobility that warrant handing over process include intra and inter
ministerialtransfer underserviced transfer across the nation, withdrawal, voluntary and
compulsory retirement.

The need to achieve continuity as a necessary demand of constantly changing positions in the
civil service makes the handing over process an imperative. Of course, the handing over
process is one of the mechanisms by which continuity is achieved in both public and civil
service. Also, the operative instrument in the handing over process is the handover notes.

All officers involved in movement within the service are to properly participate in handing
over process by either prepare, receive or sign the handover notes to ensure continuity in the
administration. When handing over process is properly handled, it can easily facilitate the
incoming officer’s understanding of the goals, aspirations and intentions of his Ministry as
well as problems and constraints in the way of effective performance. In short, Any officer in
the service who is about to leave his/her position permanently is required to write handover
notes or an officer leaving his position/job schedule to assume new responsibilities within the
same ministry, department or unit.
HANDOVER NOTES:

 Handover notes are briefs prepared by outgoing schedule officers to guide their
successors. The handover notes is important to provide the incoming officer with
necessary ideas, information and insights into the specifics of the new schedule,
challenges, constraints, achievements and may reflect future projection.
 A well prepared handover notes assist the incoming officer to settle down on time
and understand with ease the demand of the new office so as to make the
transition period to be short and smooth.
 The best period to finalize handover notes is during the week the officer is leaving
the position. Ideally, there should be a period of overlap with the staff member’s
successor allow for interactions, necessary exchanges and opportunity to clarity
issues. Some officers hold erroneous impression that handover notes is meant to
 probe or witch-hunt the predecessors, whereas it is intended to acculturate or
assimilate the incoming officer into the culture, practice or job tasks.
 As an organizational instrument, handover notes should be rich in brevity, precision,
coherence arm free and should be devoid of ambiguity. As a matter of fact, handover
notes are to be factual rather than analytical.

GUIDELINES FOR EFFECTIVE PREPARATION FOR HANDOVER NOTES:

The style, arrangement and contents of handover notes may vary from one ministry or extra
ministerial department to another across the nation. However, the below template is presented
as fitted into the common practice in civil/public service:
 The Heading
 Introduction/Preamble
 Description of schedule of duty/job tasks
 Office Routine
 Unfinished and Pending matters
 Problems and Constraints relating to the schedule being handed over
 Inventory of assets, office furniture, equipment, files and other records
 Signatures
 THE HEADING: Heading is the title of handover notes and it always indicates
name and post; the officer who is handing over and the one taking over; month and
year of the exercise.
 The ministry or extra ministerial departments in which the handing over process is
being affected needs to be indicated. As an illustration, we may have a heading
such as Oyo State Ministry of Education, May 2014: Handing over Notes from
Mr. S.A Emiola, Director High Education, to Mr. N.A Sheu, the Director Primary
Education. The heading should at a glance show who and who are involved in the
handing over exercise and where and when.

 INTRODUCTION: The introduction or preamble to the notes often consists a short

outline of the prevailing circumstances under which the outgoing officer assumed
responsibility/took over the schedule. The introductory aspect is expected to cover
brief/ information on when, from who and to where he is moving after handing over.
Information about the new place of assignment may be necessary in case the outgoing
officer needs to be contacted for clarification in the future.

 DESCRIPTION OF THE SCHEDULE: This section of the handover notes

captured the nature of the schedule and the operational guidelines. Here, an outgoing
officer is requiredto summarize the job tasks, duties and responsibilities as succinctly
as possible. Similarly, it makes good sense to start this section with a brief run-down
on the structure or organ gram of the department/unit including other officers who
work up to, down to or with the outgoing officer. This is particularly indicated where
the outgoing officer is the head of the unit.

 OFFICE ROUTINE: This aspect of the handover notes should describe or outline
the procedure, processes or fixed ways of performing the duties. Under office routine,
the outgoing officer is expected to outline the various meetings of the unit and their
time, venue and frequency. The nature and status of the various meetings need to be
indicated; for example, meetings which are statutorily specified in the enabling
instruments of the parastatal or board need to be indicated.
 UNFINISHED AND PENDING MATTERS: This is an aspect of handover notes
where ongoing projects, unfinished businesses and pending transactions are listed.
While listing current projectsyou are working on, provide the start date, the goal,
employees participating on the project with you or employees who provide resources
for the project, information related to cost and budgeting and the anticipated
completion date. If your job is heavily focused on project works, summarize the
purpose or intent of each project, as well as the expected outcomes. Here, priority
attention needs to be paid to matters being kept in view, matters which are to be
brought up on future dates for consideration, letters whose replied are still being
awaited, memoranda or enquiries from outside agencies as well as the dates of
impending meetings. With effective handling of this aspect of handover notes the new
schedule officer will know where to start and this will guarantee continuity of
operations.
 PROBLEMS AND CONSTRAINTS: Under this section of the handover notes, the
outgoing officer is expected to state the problems and constraints which militated
against efficient and satisfactory performance of the schedule. It is desirable that an
outgoing officer should proffer suggestions on measures to be taken to improve on the
performance.

 INVENTORY OF ASSESS, OFFICE FURNITURE, EQUIPMENT, AND FILES

AND OTHER RECORDS: It is conventional to present in the last major paragraphs
of handover notes a list of the office furniture, equipment or any other important
records including reference materials and reports, which are being handed over.
Records of inventory shall be helpful to an outgoing officer in the preparation of his
handover notes.
 SIGNATURES: As a matter of convention, handover notes usually ends in a format
which provides space for the names, designations, date and signatures of the two
officers involved in the handing over exercise. The actual handing over process
requires that the two officers involved should meet, exchange ideas and seek
clarifications where necessary. Essentially, both the outgoing and the incoming officer
are to sign the handover notes usually in triplicateat the end of the handing over
exercise, if they are mutually satisfied. The original of the signed notes is filed, while
the duplicate and triplicate copies are retained by the officer who has taken over and
the outgoing officerrespectively. Information provided in the handover notes should
 not only be sufficient, but must be complete. An incomplete or inaccurate handover
notes may pose potential problems for the two officers involved in handing over
exercise.

PATIENTS HANDOVER CONSISTS::

HANDOVER ABOUT PATIENT:-

1. Client name, age, marital status, religious preferences, physician and family
contact.
2. Medical diagnosis: listed by priority
3. Nursing diagnosis: listed by priority
4. Allergies
5. Medical orders: diet, medications, intravenous(IV) therapy, treatments,
diagnostic tests and procedures (including dates and results), consultations,
DNR order (when appropriate)
6. Activities permitted: functional limitations, assistance needed in activities of
daily living and safety precautions.
7. Change of shift report should not simply be reading documented
information. Instead significant information about clients are reviewed
 EXAMPLE: OF PATIENT HANDOVER

 BACKGROUND INFORMATION:Mr. Aman Singh in bed 3, a 68 years client of

Dr. _____ is scheduled for CABG this morning. He had severe Angina. He was
admitted last night with chest pain and dyspnoea. This is first experience with
invasive procedure. He knows he may require PTCA according to vessels condition.
 ASSESSMENT: Mr. Om Singh expressed difficulty in falling asleep last night. He
had several questions about procedure.
 NURSING DIAGNOSIS: his chief concerns are anxiety related to inexperience with
invasive procedure.
 TEACHING PLAN: he asks appropriate questions about surgery. Staff on evenings
explained postoperative routines. I reinforced information with him early in the night.
He stated that he feels less anxious that he knows more what to expect.
 TREATMENTS: Tab Sorbitarte sublingual administered and patient put on
humidified oxygen. The blood sample had taken and sends to laboratory for various
 Examinations. ECG was taken at the time of admission.
 ALLERGIES: patient doesn’t have any allergic history.
 PRIORITY NEEDS: currently, Aman Singh is relaxing in bed. The consent form has
been signed. All preoperative preparation and checklist have been completed.

DO’S DONT’S

 Provide only essential  Don’t review all routine care

background information about procedures or tasks (e.g. bathing
client (i.e. name, sex, age scheduled changes).
physician’s diagnosis, and  Don’t review all biographical
medical history). information already available in
 Identify client’s nursing diagnosis written form.
or health care problems and their  Don’t use critical comments about
related causes. client’s behaviour, such as “Mrs. Gill
 Describe objective measurements is so demanding.”
or observations about clients  Don’t make assumptions about
condition and response to health relationships between family
 problem: emphasize recent members.
changes  Don’t engage in idle gossip.
 Share significant information  Don’t describe basic steps of a
about family members as it procedure
relates to client’s problems  Don’t explain detailed content unless
 Continuously review ongoing staff members ask clarification
discharge plan (e.g. need for  Don’t simply describe results as
resources, client’s level of “good” or “poor”. Be specific
preparation to go home)  Don’t force oncoming staff to guess
 Relay to staff significant changes what to do first.
in the way therapies are give (e.g.
different position for pain relief,
new medication)
 Describe instructions given in
teaching plan and client’s
response.
 Evaluate results of nursing or
medical care measures (e.g.’
effect of back rub or analgesic
administration).
 Be clear about priorities to which
oncoming staff must attend.