Complete Nursing Handover Guide

ISBAR stands for:

ISBAR	What it means	Purpose
I — Identify / Introduction	Identify yourself and the patient	Establish who is communicating and which patient is being discussed
S — Situation	Explain the current situation	State what is happening and why you are communicating
B — Background	Provide relevant background information	Give the clinical history and information needed to understand the situation
A — Assessment	Communicate your assessment	Explain the patient’s current condition and your clinical concerns
R — Recommendation	State what is required next	Clearly communicate what action, review or follow-up is needed

The Australian Commission on Safety and Quality in Health Care identifies ISBAR as one example of a structured clinical handover tool. Its ISBAR resources describe the framework as Introduction, Situation, Background, Assessment and Recommendation, although terminology can vary slightly between ISBAR versions and healthcare organisations. [1]

1. Why is ISBAR Important?

Clinical handover involves transferring professional responsibility and accountability for some or all aspects of a patient’s care to another person or professional group. Important information can be missed or misunderstood when communication is incomplete, unclear or poorly structured. [1]

Using a structured approach helps clinicians organise the information being communicated and focus on what the receiving clinician needs to safely continue care. The NSQHS Communicating for Safety Standard requires health service organisations to have structured clinical handover processes and requires clinicians to use these processes when transferring care. [1]

Student Note: Think of ISBAR as a communication structure, not a script to memorise word-for-word. Your handover should remain concise and relevant while including the information required for the patient’s situation and your healthcare service’s local handover process.

2. Why Structured Clinical Handover Matters

Clinical handover is a critical point in patient care because responsibility and accountability for care are transferred between clinicians. The information communicated during handover needs to be accurate, relevant, timely and sufficiently complete to allow the receiving clinician to safely continue the patient’s care. [1]

Communication and Patient Safety

Communication failures during transitions of care can contribute to misunderstandings, omissions and errors. A structured handover framework provides a consistent way to organise important information, helping clinicians communicate the patient’s current condition, relevant background, risks and ongoing care needs. [1]

• Organise information in a consistent and logical sequence
• Reduce the risk of important information being omitted
• Communicate the patient’s current condition and clinical risks
• Clarify ongoing care requirements and responsibilities
• Provide an opportunity for questions and clarification
• Support continuity of care
• Improve communication between members of the healthcare team
• Support the involvement of patients, carers and families, according to the patient’s wishes

What Does the Evidence Show?

Research generally supports the use of structured nursing handover tools such as ISBAR and SBAR to improve the organisation, completeness and consistency of clinical communication. However, the effect on patient outcomes can vary between clinical settings, and effective implementation also depends on factors such as staff training, local processes and the context in which handover occurs. [2]

3. I — Identify / Introduction

The Identify/Introduction stage establishes who is communicating and confirms the identity of the patient being discussed. Begin by introducing yourself and your role, then correctly identify the patient using the approved identification processes of your healthcare service. [1]

Introduce Yourself

At the beginning of the handover, clearly identify yourself so the receiving clinician knows who is communicating and where the information is coming from.

Include:

• Your name
• Your role
• Your clinical area or location
• The reason for the communication, when appropriate

Identify the Patient

Correct patient identification is an essential safety step during clinical handover. The NSQHS Communicating for Safety Standard requires healthcare organisations to use at least three approved patient identifiers whenever clinical handover or patient transfer occurs. [1]

Examples of identifiers that may be approved by a healthcare organisation include:

• Patient’s full name
• Date of birth
• Healthcare record number
• Address
• Individual Healthcare Identifier (IHI)

Example: Identification / Introduction

Let’s use a fictional patient:

Mrs Ruby Tolarni, 70 years old, admitted with a urinary tract infection and now becoming increasingly confused and fatigued.

For I — Identify, the example could be:

“Hi, my name is Alex, and I’m the student nurse working with the RN on the medical ward. I’m handing over Mrs Ruby Tolarni. Her identity has been confirmed using the healthcare service’s approved patient identifiers.”

4. S — Situation

The Situation component communicates what is happening with the patient right now and why the handover or clinical communication is occurring. It should be brief and focused on the immediate clinical concern, including whether the patient is stable, deteriorating or otherwise requires attention. [1]

What to Include in the Situation

Keep the Situation concise and communicate the most important current information, such as:

• The immediate reason for the handover or communication
• The patient’s current clinical problem or concern
• Whether their condition is stable, improving or deteriorating
• Important new or recent changes
• The urgency of the situation, where relevant

Ask Yourself

Example: Mrs Tolarni

Let’s continue our fictional patient.

We previously established:

Mrs Ruby Tolarni, 70 years old
Admitted with a urinary tract infection
Now increasingly confused and fatigued

Her S — Situation could be:

“Mrs Tolarni was admitted with a urinary tract infection. She has become increasingly confused and fatigued, and I am concerned about a change in her clinical condition.”

Situation: Weak vs Strong Example

Less effective	More effective
“I’m calling about Mrs Tolarni. She doesn’t seem right.”	“Mrs Tolarni has become increasingly confused and fatigued, and I’m concerned about a change in her clinical condition.”
Gives little specific information	Identifies the current change and communicates concern

5. B — Background

The Background component provides the relevant clinical information needed to understand the patient’s current situation. Include information that helps explain the present concern and supports safe continuation of care, while avoiding unnecessary details that do not contribute to the immediate handover. [1]

What to Include in Background

Depending on the patient and reason for handover, relevant background may include:

• Reason for admission or presenting problem
• Relevant medical and surgical history
• Date of admission, where relevant
• Relevant medications or recent treatments
• Allergies and alerts
• Recent significant investigations or test results
• Relevant previous or recent observations
• Important changes in clinical status
• Relevant risks, precautions or ongoing care requirements

Not every item needs to be included in every ISBAR. Select the background information that is relevant to the patient’s current situation and the purpose of the communication.

Relevant vs Unnecessary Information

Less useful approach	More effective approach
Reading the patient’s entire medical history	Provide history relevant to the current concern
Listing every medication	Highlight medications relevant to the situation
Reporting every investigation result	Communicate significant or relevant results
Repeating information already established	Focus on information needed to understand the current situation
Giving unrelated details	Keep the background clinically relevant and concise

Background should provide context—not overwhelm the receiving clinician with information.

Example: Mrs Tolarni

Let’s add a little more fictional information to our case:

• 70 years old
• Admitted with a urinary tract infection
• Receiving prescribed antibiotics
• Oral intake has been reduced
• Increasing confusion and fatigue compared with earlier assessment

Her B — Background could therefore be:

“Mrs Tolarni was admitted with a urinary tract infection and is receiving prescribed antibiotics. Her oral intake has been reduced, and her confusion and fatigue have increased compared with earlier assessments.”

Keep Background Separate From Assessment

Background = what has happened / relevant context

“She was admitted with a UTI and has had reduced oral intake.”

Assessment = what you have assessed about her condition now

“Her current observations are…, she appears…, and my assessment is…”

6. A — Assessment

The Assessment component communicates the patient’s current clinical condition based on your assessment findings. Report relevant observations, examination findings and significant changes or trends, and clearly communicate any clinical concern. [1]

What to Include in Assessment

• Vital signs and observations
• Focused physical assessment findings
• Changes from the patient’s baseline or previous observations
• Pain or other significant symptoms
• Fluid balance, intake or output where relevant
• Level of consciousness or neurological changes
• Relevant investigation results, if known
• Response to interventions or treatment
• Any other findings directly related to the current concern

Avoid simply listing every observation available. Prioritise findings that help the receiving clinician understand the patient’s current condition, particularly abnormalities and important trends.

For example:

Less informative: “Her respiratory rate is 24.”

More informative: “Her respiratory rate has increased from 18 to 24 breaths/min.”

The second statement tells the receiving clinician that there has been a change, not merely what the current number is.

Example: Mrs Tolarni

Let’s give our fictional patient a realistic set of educational example observations:

Assessment	Finding
Temperature	38.2°C
Heart rate	104 beats/min
Blood pressure	102/64 mmHg
Respiratory rate	24 breaths/min
SpO₂	96% on room air
Neurological status	Increasing confusion compared with earlier assessment
Oral intake	Reduced

“On assessment, Mrs Tolarni’s temperature is 38.2°C, heart rate 104 beats/min, blood pressure 102/64 mmHg, respiratory rate 24 breaths/min and SpO₂ 96% on room air. She is more confused than on my earlier assessment and her oral intake remains reduced. I am concerned that her clinical condition is deteriorating.”

Educational example: These observations are fictional and are provided to demonstrate ISBAR communication. In clinical practice, interpret observations using the patient’s condition, baseline, relevant observation chart and your healthcare service’s escalation criteria.

Assessment vs Diagnosis

When communicating your assessment, distinguish between what you have observed and a diagnosis that has not been established. Nurses should communicate clinical concern clearly without presenting an unconfirmed diagnosis as fact.

For example:

Avoid saying: “She is septic.”

unless this has been clinically established.

Preferable: “She has developed fever, tachycardia, increased respiratory rate and increasing confusion, and I’m concerned that her condition is deteriorating.”

7. R — Recommendation

The Recommendation component communicates what action, review, follow-up or ongoing care is required. Clearly state what you are requesting or what needs to happen next, and confirm that the receiving clinician understands the plan and any transfer of responsibility. [1]

What to Include in Recommendation

Depending on the clinical situation, the Recommendation may include:

• The review or assistance required
• How urgently the patient needs review
• Ongoing monitoring or reassessment
• Required investigations or interventions that have already been planned or ordered
• Outstanding tasks or follow-up
• Relevant care priorities
• Who will be responsible for the next action
• When the patient should be reviewed again
• What should occur if the patient’s condition worsens

The recommendation should be clear and appropriate to your role, scope of practice and the clinical situation. If you are escalating a concern, clearly communicate what assistance or review you are requesting rather than assuming the receiving clinician knows what you need.

Be Clear About What You Need

Less effective: “That’s everything about Mrs Tolarni.”

More effective: “I’m concerned about her deterioration and would like her reviewed promptly.”

Less clear	More effective
“Can you have a look when you can?”	“I’m concerned about her deterioration and would like her reviewed promptly.”
“Just letting you know.”	“Could you please review her and advise on the next steps?”
“We’ll keep watching her.”	“We will continue observations and reassess her while awaiting review.”

For a real patient, the urgency and escalation pathway should be determined using the patient’s condition and the healthcare service’s local criteria.

Example: Mrs Tolarni

We established that Mrs Tolarni has:

• Increasing confusion and fatigue
• Temperature 38.2°C
• HR 104 beats/min
• BP 102/64 mmHg
• RR 24 breaths/min
• SpO₂ 96% on room air
• Reduced oral intake

For R — Recommendation, let’s use: “I’m concerned that Mrs Tolarni’s condition is deteriorating. I would like her to be reviewed promptly. We will continue to monitor and reassess her while awaiting review and escalate further if her condition worsens, according to the local escalation pathway.”

Educational example: The appropriate response, urgency and escalation pathway depend on the patient’s clinical condition and the healthcare service’s local recognition and response system. Nursing students should escalate concerns to their supervising registered nurse and follow their placement organisation’s procedures.

Confirm the Plan

Effective handover should provide an opportunity for the receiving clinician to ask questions, clarify information and confirm the ongoing plan of care. [1]

Before finishing, clarify:

• What happens next
• Who is responsible for the next action
• Whether anything remains outstanding
• Whether the receiving clinician has questions
• That important information has been understood

8. How to Prepare Before an ISBAR Handover

Effective clinical handover begins before the conversation starts. Where the clinical situation allows, review the relevant patient information, organise the key points you need to communicate and identify any outstanding concerns or actions. Preparation can help make the handover clear, concise and clinically relevant. [1]

Before You Begin

Where appropriate, check the following:

• Confirm the patient’s identity using the healthcare service’s approved identifiers.
• Review the reason for admission and relevant clinical history.
• Check the latest vital signs and observations.
• Review important changes or trends in the patient’s condition.
• Review relevant assessment findings.
• Check relevant medications and recent treatments.
• Confirm allergies, alerts and clinical risks.
• Review significant investigation or test results, where relevant.
• Identify outstanding investigations, treatments or care tasks.
• Consider the patient’s current goals and priorities of care, where relevant.
• Identify anything requiring review, follow-up or escalation.
• Organise the information into I–S–B–A–R before beginning the handover.

The information required will depend on the type of handover and the patient’s clinical situation. Avoid collecting or communicating information simply because it is available; prioritise information that the receiving clinician needs to safely continue care.

Use the Most Current Information

Before handover, check that the information you intend to communicate is current. Recent observations, changes in the patient’s condition, new treatments, investigation results or changes to the care plan may alter what needs to be handed over.

Student Note: Do not rely on memory alone. Where appropriate, use the patient’s current clinical record, observation chart and approved handover documentation to support an accurate handover while maintaining patient privacy and confidentiality.

Minimise Interruptions Where Possible

Where the clinical environment allows, conduct handover in a way that supports attention and clear communication. Avoid unnecessary interruptions and distractions, while ensuring urgent patient care is always prioritised.

Protect the patient’s privacy and confidentiality when discussing clinical information, particularly in shared or public areas.

Prepare Your ISBAR

Before speaking, ask youself…	ISBAR
Who am I and which patient am I discussing?	I — Identify / Introduction
What is happening right now?	S — Situation
What relevant information explains the situation?	B — Background
What have I assessed and what has changed?	A — Assessment
What needs to happen next?	R — Recommendation

What if the Patient Is Deteriorating?

Preparation should not delay urgent assessment or escalation. If the patient is acutely deteriorating or requires immediate assistance, follow the healthcare service’s recognition and response procedures and communicate the critical information available at the time. Additional information can be provided as the situation develops.

9. Complete ISBAR Handover Example – Mrs Ruby Tolarni

The following fictional example demonstrates how the individual components of ISBAR can be combined into a structured clinical handover. The information communicated in practice should be adapted to the patient, clinical situation, healthcare setting and local handover requirements.

Educational example: Mrs Tolarni is a fictional patient and the observations in this example are provided for learning purposes only. They should not be interpreted as universal deterioration or escalation thresholds. In clinical practice, use the patient’s presentation, relevant observation chart, local escalation criteria and your healthcare service’s policies. Nursing students should communicate concerns to their supervising registered nurse and follow their placement organisation’s procedures.

10. Common ISBAR Mistakes to Avoid

ISBAR provides a structure for clinical communication, but using the five headings alone does not automatically make a handover effective. Information should still be accurate, relevant, current and appropriate to the clinical situation. [1]

Common Mistakes

Common mistake	Why it matters	Better approach
Not correctly identifying the patient	Creates a risk of information being associated with the wrong patient	Follow the healthcare service’s approved patient-identification process
Giving a long Situation	The immediate concern can become unclear	State the current problem and reason for communication early
Providing too much Background	Important information may become buried among irrelevant details	Include background relevant to the current situation and ongoing care
Reading the entire chart	Does not prioritise what the receiving clinician needs to know	Select current, clinically relevant information
Reporting numbers without context	Isolated observations may not show whether the patient’s condition has changed	Communicate important trends and changes from baseline where available
Using vague language	Phrases such as “not looking good” provide limited clinical information	Describe objective findings and clearly state your clinical concern
Presenting an assumption as a diagnosis	May communicate an unconfirmed conclusion as fact	Report your findings and concern, and distinguish them from an established diagnosis
Leaving out the Recommendation	The receiving clinician may not know what action or follow-up is required	Clearly state what review, action or ongoing care is needed
Not clarifying responsibility	Tasks or follow-up may be missed	Confirm the ongoing plan and who is responsible where appropriate
Not allowing questions	Misunderstandings or missing information may remain unresolved	Provide an opportunity for questions and clarification

Avoid Information Overload

More information does not necessarily mean a better handover. Prioritise information that helps the receiving clinician understand the patient’s current condition, risks, recent changes, care requirements and what needs to happen next.

Relevant does not mean everything you know about the patient. It means what the receiving clinician needs to safely continue care.

Avoid Vague Clinical Language

Instead of saying…	Communicate more specifically…
“She doesn’t look right.”	“She is increasingly confused compared with my earlier assessment.”
“Her observations aren’t good.”	“Her respiratory rate has increased from 18 to 24 breaths/min.”
“She’s not eating much.”	“Her oral intake has been reduced during this shift.”
“Can someone look at her?”	“I’m concerned about her deterioration and would like her reviewed promptly.”

Objective information makes the concern easier for the receiving clinician to understand. However, clinical concern itself is also important—if you are worried about a patient, communicate that concern clearly.

Don’t Diagnose Beyond What You Know

ISBAR should distinguish between established information, assessment findings and clinical concern. Avoid presenting an unconfirmed diagnosis as fact.

For our Mrs Tolarni example:

Avoid saying: “Mrs Tolarni is septic.”

unless this has been clinically established.

Preferable: “Mrs Tolarni has developed fever, tachycardia, an increased respiratory rate and worsening confusion. I’m concerned that her clinical condition is deteriorating.”

11. ISBAR Documentation & Safety Considerations

ISBAR supports structured verbal communication, but safe clinical handover also requires appropriate documentation, protection of patient information and clear transfer of responsibility and accountability. Follow your healthcare service’s documentation, privacy and clinical handover policies when communicating patient information. [1]

Document Important Information

Clinical handover should be supported by accurate and up-to-date documentation. Important changes in the patient’s condition, critical information, risks, reassessment findings and changes to the care plan should be documented according to local requirements. [1]

Good clinical documentation should be:

• Accurate — correctly reflects the patient’s condition and care.
• Relevant — includes information required for safe ongoing care.
• Complete — captures important clinical information.
• Timely — documented as close as appropriate to the event or assessment.
• Objective — uses clear clinical information rather than unsupported assumptions.
• Readable and understandable — uses approved terminology and avoids ambiguous abbreviations.
• Up to date — reflects new findings, reassessments and changes to care.

ISBAR Does Not Replace the Healthcare Record

A verbal ISBAR handover does not replace required documentation in the patient’s healthcare record. Document assessments, interventions, changes in condition, escalation, reassessment and other required information according to your healthcare service’s policies and your scope of practice.

Maintain Privacy and Confidentiality

Patient information communicated during handover must be handled in a way that protects privacy and confidentiality. Consider who can hear or access the information and use approved clinical communication and documentation systems. [1]

• Avoid unnecessarily discussing identifiable patient information in public areas.
• Share clinical information with the appropriate people involved in the patient’s care.
• Use approved healthcare-service systems for clinical information.
• Protect written and electronic patient information from inappropriate access.
• Follow local privacy, confidentiality and documentation requirements.

Transfer of Responsibility and Accountability

Clinical handover involves more than transferring information. It also involves the transfer of professional responsibility and accountability for some or all aspects of the patient’s care. The handover process should make clear who is assuming responsibility for ongoing care and any outstanding actions. [1]

Before completing handover, clarify where relevant:

• Who is assuming responsibility for the patient’s care?
• Are any tasks or investigations outstanding?
• Is further assessment or review required?
• Are there important risks or safety concerns?
• Does anything require follow-up or escalation?
• Has the ongoing plan been understood?

Involve the Patient, Carer or Family

Patients should be supported to participate in clinical handover according to their wishes and the clinical context. Where appropriate, carers and family members may also be involved in accordance with the patient’s wishes. [1]

Patient involvement can provide an opportunity to clarify information, communicate goals and preferences, ask questions and identify information that may otherwise be missed.

Communicate New Critical Information Promptly

Do not wait until the next routine handover to communicate important new deterioration, risks or critical information. New or changing critical information should be communicated promptly to clinicians who can assess the situation and take appropriate action. [1]

12. Quick ISBAR Reference / Checklist

Use this checklist as a quick revision guide when preparing for a structured clinical handover. The information required will vary according to the patient, clinical situation, type of handover and local healthcare service requirements. [1]

Quick ISBAR Checklist

ISBAR	Ask yourself	Key information to communicate
I — Identify / Introduction	Who am I, and which patient am I discussing?	Introduce yourself, your role and clinical area. Correctly identify the patient using the healthcare service’s approved identification process.
S — Situation	What is happening right now?	State the immediate reason for handover, the current problem or concern, and any important recent change.
B — Background	What relevant information explains the situation?	Provide relevant admission details, clinical history, treatments, allergies/alerts, risks and significant recent information.
A — Assessment	What have I assessed, and what has changed?	Report relevant observations, focused assessment findings, significant trends, response to treatment and your clinical concern.
R — Recommendation	What needs to happen next?	State the required review, action, monitoring or follow-up. Clarify outstanding tasks and responsibilities where appropriate.

Before You Finish the Handover

Short checklist:

☐ Have I identified the correct patient?

☐ Have I clearly explained the current situation?

☐ Is the background information relevant?

☐ Have I communicated important assessment findings and trends?

☐ Have I clearly stated my clinical concern, where applicable?

☐ Have I explained what needs to happen next?

☐ Are any outstanding tasks or risks clear?

☐ Is it clear who is responsible for ongoing care or follow-up?

☐ Has the receiving clinician had an opportunity to ask questions or clarify information?

Student Note: Before beginning handover, mentally organise the information into five questions: Who? What is happening? What is the relevant background? What have I assessed? What needs to happen next? This can help you communicate in a logical sequence without simply reading information from the patient’s record.

ISBAR is a communication framework, not a substitute for clinical assessment or escalation. If a patient is acutely deteriorating or requires urgent assistance, follow the healthcare service’s recognition and response procedures. Do not delay escalation while trying to prepare a perfect handover.

13. When to Escalate Concerns

ISBAR can be used to communicate concerns when a patient’s condition changes or deteriorates. However, ISBAR is a communication framework, not an escalation system. Clinicians should recognise deterioration, respond within their scope of practice and escalate care using the healthcare service’s local recognition and response procedures. [3]

When Should You Escalate?

Escalation may be required when assessment findings, changes from baseline or clinical concern suggest that the patient requires additional or more urgent review.

Examples include:

• A clinician being worried or concerned about the patient, even when other escalation criteria have not yet been reached
• Vital signs reaching the healthcare service’s escalation criteria
• A significant or concerning change in observations
• New or worsening physiological deterioration
• Acute changes in cognition, behaviour or mental state
• Increasing pain or distress that is not adequately managed
• A rapid change in the patient’s clinical condition
• New or increasing safety concerns
• Concern expressed by the patient, family or carer

Do Not Wait for a Number

Do not rely on a single vital-sign threshold before communicating concern. Consider the patient’s overall clinical presentation, changes from baseline, trends over time and your clinical judgement.

Use ISBAR During Escalation

When escalating care, ISBAR can help organise the critical information so the receiving clinician quickly understands the problem, relevant background, current assessment and what assistance is required.

A concise escalation could sound like:

I: “Hi, I’m Alex, the student nurse working with the RN caring for Mrs Tolarni.”

S: “She has become increasingly confused and fatigued, and I’m concerned that her condition is deteriorating.”

B: “She was admitted with a urinary tract infection, is receiving antibiotics and has had reduced oral intake.”

A: “Her temperature is 38.2°C, HR 104, BP 102/64, RR 24 and SpO₂ 96% on room air. Her confusion has increased compared with earlier.”

R: “I’m concerned about the change in her condition and would like her reviewed promptly.”

Educational example: The appropriate response and urgency should be determined using the patient’s clinical condition and the healthcare service’s local escalation criteria.

If the Patient Continues to Deteriorate

If the patient’s condition continues to deteriorate, the requested response does not occur within the required timeframe, or you remain concerned, continue to use the healthcare service’s escalation pathway to obtain appropriate assistance.

Nursing students should promptly communicate concerns to their supervising registered nurse and follow the placement organisation’s recognition and response procedures.

14. Key Takeaways

ISBAR provides a structured approach to clinical communication that can help healthcare professionals organise and communicate important patient information during clinical handover and escalation. Effective handover involves more than following the five letters—it requires accurate information, clinical judgement, clear communication and confirmation of what needs to happen next. [1]

Key Points:

• I — Identify / Introduction: Introduce yourself and correctly identify the patient using the healthcare service’s approved patient-identification process.
• S — Situation: Clearly state what is happening with the patient now and the immediate reason for the handover or communication.
• B — Background: Provide relevant clinical information that helps the receiving clinician understand the current situation.
• A — Assessment: Communicate current assessment findings, important changes or trends and your clinical concern.
• R — Recommendation: Clearly state what review, action, monitoring or follow-up is required and clarify responsibilities where appropriate.
• Prepare before handover when the clinical situation allows, using current and relevant patient information rather than relying on memory alone.
• Communicate changes and concerns promptly. ISBAR can structure escalation, but preparing a handover should never delay urgent assistance.
• Protect privacy and confidentiality, document required clinical information and provide an opportunity for questions and clarification.
• Follow local procedures. Handover requirements, escalation criteria and recognition-and-response systems vary between healthcare services.

References

[1] Australian Commission on Safety and Quality in Health Care. (n.d.). Communicating for Safety Standard. Australian Commission on Safety and Quality in Health Care. Communicating for Safety Standard

[2] Rasiya, A., & Raheem, U. A. (2026). Shift transition communication among nurses: A systematic review of ISBAR and SBAR-based structured handover tools. Nursing Open, 13(7), e70655. https://doi.org/10.1002/nop2.70655

[3] Australian Commission on Safety and Quality in Health Care. (n.d.). Recognising and Responding to Acute Deterioration Standard. Australian Commission on Safety and Quality in Health Care.