Prepare the Next Team: Healthcare Shift Handover Checklist

1. Administrative Details

Date

Shift Type

Morning

Afternoon

Night

Outgoing Staff Name

Role

Incoming Staff Name

Role

Unit/Ward/Department

2. Patient/Client Status (The SBAR Section)

Duplicate this section for each patient under your care.

	Item	Check?
	A	B
1	[S] Situation
2	Patient Name and Age/DOB.
3	Primary diagnosis or reason for admission/visit.
4	Current clinical status (Stable, Guarded, Critical).
5	[B] Background
6	Relevant medical history (Allergies, chronic conditions).
7	Recent procedures or surgeries (within the last 24–48 hours).
8	Current medications and last doses administered.
9	[A] Assessment
10	Vital Signs: Latest readings and any significant fluctuations.
11	Physical State: Pain levels, mobility, skin integrity, mental state.
12	Equipment: IV lines, catheters, oxygen, or monitoring devices in use.
13	Risk Assessment: Fall risk, pressure sore risk, or behavioral alerts.
14	[R] Recommendation
15	Immediate tasks required (pending labs, scans, or meds).
16	Changes to the care plan for the upcoming shift.
17	Specific "Watch-Outs" (symptoms that require immediate escalation).

3. Environment & Inventory Check

	Item	Check?
	A	B
1	Medication Count: Confirm narcotics/controlled substances are reconciled.
2	Equipment Check: All necessary medical devices are present and functional (e.g., suction, crash cart).
3	Supply Levels: Restocking needed for immediate use items (gloves, dressings, etc.).
4	Room Status: General cleanliness and safety hazards identified.

4. Coordination & Communication

	Item	Check?
	A	B
1	Family/Guardian Updates: Summarize what has been communicated to family.
2	Multidisciplinary Notes: Updates from doctors, therapists, or social workers.
3	Pending Orders: High-priority orders that were not completed during the previous shift.

5. Sign-Off

By signing below, the outgoing staff confirms all critical information has been relayed, and the incoming staff confirms they have had the opportunity to ask clarifying questions.

Outgoing Signature

Incoming Signature

Form Template Insights

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Detailed Insights on the Healthcare Shift Handover Checklist Template

1. The Power of the SBAR Structure

The SBAR (Situation, Background, Assessment, Recommendation) framework is used because it categorizes information by urgency and relevance.

Contextual Clarity: It prevents "storytelling" where unnecessary details bury the important facts.
Critical Thinking: It forces the outgoing staff to not just report numbers (Assessment), but to suggest a path forward (Recommendation).

2. Vital Signs & Clinical Trends

In a template, "Assessment" should focus on trajectories rather than single data points.

The "Why": A blood pressure reading of 110/70 is fine in isolation, but if the patient was 140/90 an hour ago, that downward trend is the real story.
Tip for your template: Include a small space for "Trends" or "Changes from Baseline" to capture movement in health status.

3. Risk Assessment & Safety Alerts

This section acts as a "Red Flag" system. It focuses on the physical safety of the patient and the staff.

Environmental Awareness: Includes notes on whether a patient is a flight risk or has specific physical triggers.
Fall Prevention: Marking a patient as a "High Fall Risk" ensures the incoming shift knows to keep bed rails up or keep mobility aids within reach immediately.

4. Closed-Loop Communication (The Sign-Off)

The signature block is more than a formality; it is a confirmation of shared mental models.

Interactive Handover: The sign-off implies that a conversation happened. It encourages the incoming professional to ask, "What is the one thing I should be most worried about with this patient tonight?"
Accountability: It creates a clear timestamp of when care responsibility transitioned from one person to another.

5. Continuity of Human Connection

Healthcare involves more than biological data; it involves people.

Social & Emotional Context: Insights into a patient’s mood or family dynamics (e.g., "Daughter is visiting at 6 PM and is very anxious") help the incoming shift manage the environment more smoothly.
Preference Tracking: Simple notes on how a patient prefers to be moved or their dietary quirks can significantly improve the quality of the "wellness" experience.

6. Resource & Equipment Readiness

A handover is the best time to identify "operational friction."

Inventory Integrity: Ensuring the next shift isn't hunting for bandages or a working thermometer saves time that should be spent on patient care.
Emergency Preparedness: Verifying that the crash cart or emergency oxygen is ready is a "common sense" safety check that must be habitual.

Mandatory Questions Recommendation

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Mandatory Questions & Core Rationale:

1. "What is the patient’s current clinical status and trend?"

The Elaboration: You cannot provide care without knowing the baseline. This question covers vital signs and the general "trajectory" of the individual.

The "Why": It is not enough to know a person is "stable." The incoming staff needs to know if they are improving or declining. Knowing that a pulse is rising over several hours allows the new shift to stay ahead of a potential crisis rather than reacting once it happens.

2. "Are there any known allergies or high-alert contraindications?"

The Elaboration: This is a non-negotiable safety check for every single shift change.

The "Why": Even if the information is in a digital chart, verbalizing allergies during handover prevents errors during high-speed situations (like an emergency medication administration). It keeps the most dangerous risks at the "top of mind" for the incoming staff.

3. "What specific tasks or medications are pending or overdue?"

The Elaboration: This bridge connects the work of the two shifts to ensure nothing "falls through the cracks."

The "Why": In a busy wellness or health environment, tasks like dressing changes, lab draws, or specific medication doses can easily be missed during the chaos of a shift swap. This question ensures the timeline of care remains unbroken.

4. "What are the primary safety risks (Falls, Skin, Behavior)?"

The Elaboration: This identifies the person’s immediate physical vulnerabilities.

The "Why": If a patient is a high fall risk or has a wound that is deteriorating (skin integrity), the incoming staff needs to prioritize their rounds accordingly. Knowing these risks allows the staff to organize their workflow based on who needs the most frequent monitoring.

5. "Has there been any change in the care plan or physician orders?"

The Elaboration: Healthcare is dynamic; instructions from the morning may no longer apply by the evening.

The "Why": This prevents the incoming shift from following outdated protocols. If a doctor or specialist visited at the very end of a shift and changed a dosage or a physical therapy requirement, that information must be highlighted to ensure the patient receives the most current treatment.

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