Endorsement or Handover

Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
COLLEGE of NURSING and ALLIED HEALTH SCIENCES
Name: Czarina Mae Quinones Tadeo Yr. & Section: BSN -2D Date: January 29, 2022
Patient Handover/Clinical Handover/ Patient Endorsement
Definition: Clinical handover is the transfer of responsibility and accountability for some or all aspects of
your care from one health care professional to another on a temporary or permanent basis.
During your stay in hospital, this could be from:
• one nurse to another nurse

• one doctor to another doctor
• an allied health professional (e.g., physiotherapists, occupational therapists etc.) to another.
Aim: The aim of clinical handover is to achieve effective, high-quality communication of relevant
clinical information when the responsibility of your care is transferred.
Effective clinical handover helps promote patient safety and can reduce the likelihood of incorrect
treatment, delays in diagnosis and a longer length of stay in hospital.\
Definition of Terms:
• Clinical handover: The temporary or permanent transfer of professional responsibility and

accountability for some or all aspects of care for a patient or group of patients to another
person/family/legal guardian or professional group.
• ISBAR is an acronym for Identification – Situation – Background – Assessment –
Recommendation/Response.
• Group handover: This can be done as a large group with all nurses starting the shift at the same
time, or in smaller groups of nurses working together in a pod.
• Bedside handover is a direct patient handover that takes place at the patient's bedside and
includes patients as well as parents/caregivers.
• EMR Review: the process of going through the EMR activities to collect relevant patient
information.
Management Responsibilities
Compliance with the clinical handover is the responsibility of the Nurse Unit Manager (NUM). The
Associate Unit Manager is usually in charge of the operational leadership of handover and the assignment
of nurses to patients (AUM).
The NUM and/or AUM are responsible for ensuring that the following principles are followed:
• While handover is taking place, patient care continues as needed.
• Nurses can use the Electronic Medical Record (EMR).
• The location, start times, and duration of the handover are all determined.
• The time available and clinical demands of the shift are reflected in group handover (e.g.
large group with all nurses commencing their shift or in smaller groups of nurses
working in a pod)
• Nurses are well-versed in the structure and expectations of handover.
• Disruptions are reduced.
• Handover is attended by all relevant nurses.
• ISBAR is a communication structure format.
• Patients are assigned to qualified nurses.
• Audits of the handover process are carried out as needed.
Clinical Handover
Group Handover (inpatient, ward based)

• Every day, at the time of shift change-over or shift start.
• takes place in a specific location
• The group handover is attended by all nurses, including student nurses, who are
starting a shift.
• The AUM in charge of the shift leads group handovers.
• The ISBAR format is used for structure handover (EMR handover report function
may be useful)
• Handover is carried out with minimal disruption (no mobile phones or pagers to be
answered)
• At the conclusion of the group handover, any important messages pertaining to the
ward or hospital, such as staffing, potential issues relevant to the unit's operation, are
discussed.
• The group handover is completed, allowing enough time for bedside handover
before the previous shift's nurses finish their shift.
• Handover for nurses working in the community allows adequate time to review all
documented handovers
Bedside Handover (inpatient, ward based)
• Handover occurs at each patient's bedside, involving patients, parents/caregivers, and

others.
• Handover occurs between the nurse who is in charge of the patient's care and the nurse
who will be in charge of the patient's care.
• According to the RCH Patient Identification Procedure, the positive patient identification
process occurs during bedside handover, confirming full name, date of birth, and Medical
Record Number (MRN) to the EMR.
• Clinical alerts have been identified (e.g., FYI flags, allergies, infection control precautions)
• The ISBAR format is used for structure handover.
• Patients and parents/caregivers are encouraged to participate in bedside handover and to be

aware of the next shift's plan of care.
• Patients, parents/caregivers, and nurses are encouraged to use the communication boards in
the patient room as a tool for multidisciplinary team handover.
• The handover is recorded in the EMR.
• Following the handover at the bedside, an EMR review is performed.
• Direct patient care handover may only occur in electronic documentation within the EMR
in specific clinical areas (e.g., Wallaby & Pre-op Hold).
Break Handover (inpatient, ward based)
• Handover occurs between the nurse who is in charge of the patient's care and the nurse
who will be in charge of the patient's care.
• The ISBAR format is used to structure handovers with an emphasis on ISR – identification
of the patient, current situation, and any risks or recommendations for break intervals.
Transfer of patient within the hospital (for procedure, treatment or to another ward)
• All patients transferred from one clinical area to another must have their handover
documented in the EMR. This includes information about the transfer time, which
indicates a change in professional responsibility and accountability.
• According to the RCH Patient Identification Procedure, the positive patient identification
process occurs to confirm full name, date of birth, and Medical Record Number (MRN) to
the EMR.
• Clinical alerts have been identified (e.g., FYI flags, allergies, infection control precautions,
MET modifications)
• A patient can be transported by CARPs, parents/ carers if the patient is assessed as:
• Stable
• Predictable
• Having no fluids or blood product transfusions running
• Requiring clinical observations <4 hourly
• Handover can be conducted over the phone to the receiving nurse/ AUM/
appropriate health practitioner who will then assume responsibility and
accountability for the patient
• A patient must be escorted by the nurse if the patient is assessed as:
• Unstable
• Having fluids or blood transfusions running
• Requiring clinical observations <4 hourly
• Handover occurs between the nurse that holds responsibility for care and the nurse
who will be assuming responsibility for the care of the patient
• Inpatients to theatre- Handover occurs between the nurse in charge of care and
the pre-op hold nurse, who will assume responsibility for the patient's care.
• Rosella and Butterfly patients to theatre- For Rosella inpatients being
transferred to & from theatre, clinical handover is required from the bedside nurse
to the anaesthetist
• Ambulatory Care patient to another clinical area- The nurse transferring care
contacts the relevant AUM of the receiving clinical area to ensure patient is
expected and handover is given. Relevant local administrator (Desk Staff, Ward
Clerk) to be notified of transfer or admission by the AUM
Non-Clinical Activities
• Parents, caregivers, teachers, volunteers, and others may accompany a patient off the ward
if it has been determined that the patient is safe to leave the ward without a nurse in
accordance with the Supervision and movement of inpatients across RCH and access to
inpatient areas procedure.
• If the patient is deemed safe without the presence of a nursing escort, document this in the
EMR.
• Patients colonized with a multi-resistant organism may only leave the ward/room with the
permission of the treating team or Infection Prevention and Control.
Patient Discharge
• On discharge home patients are provided with written discharge advice about the patient’s
hospital stay
• An After Visit Summary (AVS) can be printed for the parents/ carers, along with any
attendance certificates, which has a minimum data set including:
• name of consultant
• diagnosis
• medication plan
• follow up information
• phone number to contact if more information required
• The clinician documents in the EMR that the discharge advice has been given to the
parents/ carers and the time of discharge.
Patient Endorsement using SBAR Technique
Situation • Identify yourself and the site/unit you are
calling from. Identify the patient by name
and the reason for your report.
• Describe your concern.
• Firstly, describe the specific situation about
which you are calling, including patient’s
name, consultant, patient location,
resuscitation status and vital signs.
“This is Lou, a registered physical therapist

on PT Ward. The reason I’m calling is that
Mrs. Taylor in room 225 has become
suddenly short of breath, her oxygen
saturation has dropped to 88 percent on
room air, her respiration rate is 24 per
minute, her rate is 110 and her blood
pressure is 85/50.
Background • Give the patient’s reason for admission.

• Explain significant medical history.
• Overview of the patient’s background:
Admitting diagnosis, date of admission,
prior procedures, current medications,
allergies, pertinent laboratory results and
other relevant diagnostic results.
“Mrs. Taylor is a 69-year-old woman who was

admitted from home three days ago with a low
back pain. She has been on intravenous
antibiotics and appeared, until now, to be doing
well. She is normally fit and well and
independent.
Assessment • Vital signs
• Clinical impression, concerns
“Mrs. Taylor’s vital signs have been stable from

admission but deteriorated suddenly. She is also
complaining of chest pain and there appears to
be blood in her sputum. She has not been
receiving any venous thromboembolism
prophylaxis.
Recommendation • Explain what you need-be specific about
request and time frame.
• Make suggestions
• Clarify expectations
• Finally, what is your recommendation?
That is, what would you like to happen by
the end of the conversation with the
physician?
“Would you like me to get a stat CXR? And

ABGs? Start an IV? I would like you to come
immediately.”
PATIENT ASSIGNMENT SHEET

(Also utilized as summary for hand over/ endorsement)
Bibliography:
Mee, D. (2019, August). Nursing Clinical Handover. Retrieved from The Royal Children's Hospital
Melbourne:
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_clinical_handover/

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Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

COLLEGE of NURSING and ALLIED HEALTH SCIENCES

Patient Handover/Clinical Handover/ Patient Endorsement

During your stay in hospital, this could be from:

• one nurse to another nurse

• Clinical handover: The temporary or permanent transfer of professional responsibility and

Group Handover (inpatient, ward based)

• Handover occurs at each patient's bedside, involving patients, parents/caregivers, and

• Patients and parents/caregivers are encouraged to participate in bedside handover and to be

Break Handover (inpatient, ward based)

“This is Lou, a registered physical therapist

Background • Give the patient’s reason for admission.

“Mrs. Taylor is a 69-year-old woman who was

“Mrs. Taylor’s vital signs have been stable from

“Would you like me to get a stat CXR? And

PATIENT ASSIGNMENT SHEET

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