{"id":468,"date":"2026-10-01T14:01:22","date_gmt":"2026-10-01T14:01:22","guid":{"rendered":"https:\/\/nursingrules.com.au\/?page_id=468"},"modified":"2026-10-01T14:19:08","modified_gmt":"2026-10-01T14:19:08","slug":"isbar-nursing-handover-guide","status":"publish","type":"page","link":"https:\/\/nursingrules.com.au\/?page_id=468","title":{"rendered":"Complete Nursing Handover Guide"},"content":{"rendered":"\n
\n
NURSING COMMUNICATION<\/h5>\n\n\n\n

ISBAR Nursing Handover for Nursing Students<\/h2>\n\n\n\n

ISBAR<\/strong> is a structured communication framework used by healthcare professionals to organise and communicate important patient information clearly and consistently during clinical handover and other clinical communications. Structured handover supports the transfer of relevant, accurate and up-to-date information and helps maintain continuity and safety of patient care. [1]<\/p>\n<\/div>\n\n\n\n

ISBAR stands for:<\/p>\n\n\n\n

ISBAR<\/th>What it means<\/th>Purpose<\/th><\/tr><\/thead>
I \u2014<\/code> Identify \/ Introduction<\/td>Identify yourself and the patient<\/td>Establish who is communicating and which patient is being discussed<\/td><\/tr>
S \u2014<\/code> Situation<\/td>Explain the current situation<\/td>State what is happening and why you are communicating<\/td><\/tr>
B \u2014<\/code> Background<\/td>Provide relevant background information<\/td>Give the clinical history and information needed to understand the situation<\/td><\/tr>
A \u2014<\/code> Assessment<\/td>Communicate your assessment<\/td>Explain the patient’s current condition and your clinical concerns<\/td><\/tr>
R \u2014<\/code> Recommendation<\/td>State what is required next<\/td>Clearly communicate what action, review or follow-up is needed<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

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<\/strong>, although terminology can vary slightly between ISBAR versions and healthcare organisations. [1]<\/p>\n\n\n\n

1. Why is ISBAR Important?<\/h2>\n\n\n\n

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]<\/p>\n\n\n\n

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<\/strong> requires health service organisations to have structured clinical handover processes and requires clinicians to use these processes when transferring care. [1]<\/p>\n\n\n\n

Student Note:<\/strong> 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.<\/p>\n\n\n\n

2. Why Structured Clinical Handover Matters<\/h2>\n\n\n\n

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\u2019s care. [1]<\/p>\n\n\n\n

Communication and Patient Safety<\/h3>\n\n\n\n

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\u2019s current condition, relevant background, risks and ongoing care needs. [1]<\/p>\n\n\n\n

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

    What Does the Evidence Show?<\/h3>\n\n\n\n

    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]<\/p>\n\n\n\n

    \n

    Clinical Tip – Structure Does Not Replace Clinical Judgement<\/h3>\n\n\n\n

    ISBAR provides a framework for organising communication, but the information included should be relevant to the individual patient and clinical situation. A deteriorating or urgent patient may require immediate escalation rather than waiting to deliver a routine handover. Follow your healthcare service’s clinical handover and escalation procedures.<\/p>\n<\/div>\n\n\n\n

    3. I \u2014<\/code> Identify \/ Introduction<\/h2>\n\n\n\n

    The Identify\/Introduction<\/strong> 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]<\/p>\n\n\n\n

    Introduce Yourself<\/h3>\n\n\n\n

    At the beginning of the handover, clearly identify yourself so the receiving clinician knows who is communicating and where the information is coming from.<\/p>\n\n\n\n

    Include:<\/p>\n\n\n\n

      \n
    • Your name<\/strong><\/li>\n\n\n\n
    • Your role<\/strong><\/li>\n\n\n\n
    • Your clinical area or location<\/strong><\/li>\n\n\n\n
    • The reason for the communication, when appropriate<\/li>\n<\/ul>\n\n\n\n

      Identify the Patient<\/h3>\n\n\n\n

      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<\/strong> whenever clinical handover or patient transfer occurs. [1]<\/p>\n\n\n\n

      Examples of identifiers that may be approved by a healthcare organisation include:<\/p>\n\n\n\n

        \n
      • Patient’s full name<\/strong><\/li>\n\n\n\n
      • Date of birth<\/strong><\/li>\n\n\n\n
      • Healthcare record number<\/strong><\/li>\n\n\n\n
      • Address<\/li>\n\n\n\n
      • Individual Healthcare Identifier (IHI)<\/li>\n<\/ul>\n\n\n\n
        \n

        Student Note:<\/strong> A bed number or room number should not be relied upon as a patient identifier.<\/strong> Always follow your healthcare service’s approved patient-identification process.<\/p>\n<\/div>\n\n\n\n

        Example: Identification \/ Introduction<\/h3>\n\n\n\n

        Let’s use a fictional patient:<\/p>\n\n\n\n

        Mrs Ruby Tolarni, 70 years old<\/strong>, admitted with a urinary tract infection and now becoming increasingly confused and fatigued.<\/p>\n\n\n\n

        For I \u2014<\/code><\/strong> Identify<\/strong>, the example could be:<\/p>\n\n\n\n

        \u201cHi, 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.\u201d<\/strong><\/p>\n\n\n\n

        \n

        Clinical Tip – Identify Before You Handover<\/h3>\n\n\n\n

        Confirm that you are communicating about the correct patient before transferring clinical information.<\/strong> Introduce yourself clearly and use the approved patient-identification process required by your healthcare service. During clinical handover or transfer, at least three approved patient identifiers are required under the NSQHS Communicating for Safety Standard. [1]<\/p>\n<\/div>\n\n\n\n

        4. S \u2014<\/code> Situation<\/h2>\n\n\n\n

        The Situation<\/strong> component communicates what is happening with the patient right now<\/strong> 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]<\/p>\n\n\n\n

        What to Include in the Situation<\/h3>\n\n\n\n

        Keep the Situation concise and communicate the most important current information, such as:<\/p>\n\n\n\n

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

          Ask Yourself<\/h3>\n\n\n\n
          \n

          Before giving the Situation, ask yourself:<\/strong>
          \u201cWhat is the main problem with this patient right now, and why does the receiving clinician need to know?\u201d<\/p>\n<\/div>\n\n\n\n

          Example: Mrs Tolarni<\/h3>\n\n\n\n

          Let’s continue our fictional patient.<\/p>\n\n\n\n

          We previously established:<\/p>\n\n\n\n

          Mrs Ruby Tolarni, 70 years old<\/strong>
          Admitted with a urinary tract infection
          Now increasingly confused and fatigued<\/p>\n\n\n\n

          Her S \u2014 Situation<\/strong> could be:<\/p>\n\n\n\n

          \u201cMrs 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.\u201d<\/strong><\/p>\n\n\n\n

          Situation: Weak vs Strong Example<\/h3>\n\n\n\n
          Less effective<\/th>More effective<\/th><\/tr><\/thead>
          \u201cI’m calling about Mrs Tolarni. She doesn’t seem right.\u201d<\/td>\u201cMrs Tolarni has become increasingly confused and fatigued, and I’m concerned about a change in her clinical condition.\u201d<\/td><\/tr>
          Gives little specific information<\/td>Identifies the current change and communicates concern<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
          \n

          Clinical Tip – Lead With the Immediate Concern<\/h3>\n\n\n\n

          State the immediate clinical concern early.<\/strong> The receiving clinician should not have to listen to a lengthy history before understanding why you are communicating. Keep the Situation focused, relevant and appropriate to the urgency of the patient’s condition.<\/p>\n<\/div>\n\n\n\n

          5. B \u2014<\/code> Background<\/h2>\n\n\n\n

          The Background<\/strong> 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]<\/p>\n\n\n\n

          What to Include in Background<\/h3>\n\n\n\n

          Depending on the patient and reason for handover, relevant background may include:<\/p>\n\n\n\n

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

            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.<\/p>\n\n\n\n

            Relevant vs Unnecessary Information<\/h3>\n\n\n\n
            Less useful approach<\/th>More effective approach<\/th><\/tr><\/thead>
            Reading the patient’s entire medical history<\/td>Provide history relevant to the current concern<\/td><\/tr>
            Listing every medication<\/td>Highlight medications relevant to the situation<\/td><\/tr>
            Reporting every investigation result<\/td>Communicate significant or relevant results<\/td><\/tr>
            Repeating information already established<\/td>Focus on information needed to understand the current situation<\/td><\/tr>
            Giving unrelated details<\/td>Keep the background clinically relevant and concise<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

            Background should provide context\u2014not overwhelm the receiving clinician with information.<\/strong><\/p>\n\n\n\n

            Example: Mrs Tolarni<\/h3>\n\n\n\n

            Let’s add a little more fictional information to our case:<\/p>\n\n\n\n

              \n
            • 70 years old<\/li>\n\n\n\n
            • Admitted with a urinary tract infection<\/li>\n\n\n\n
            • Receiving prescribed antibiotics<\/li>\n\n\n\n
            • Oral intake has been reduced<\/li>\n\n\n\n
            • Increasing confusion and fatigue compared with earlier assessment<\/li>\n<\/ul>\n\n\n\n

              Her B \u2014<\/code><\/strong> Background<\/strong> could therefore be:<\/p>\n\n\n\n

              \u201cMrs 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.\u201d<\/p>\n\n\n\n

              Keep Background Separate From Assessment<\/h3>\n\n\n\n

              Background = what has happened \/ relevant context<\/strong><\/p>\n\n\n\n

              \u201cShe was admitted with a UTI and has had reduced oral intake.\u201d<\/p>\n\n\n\n

              Assessment = what you have assessed about her condition now<\/strong><\/p>\n\n\n\n

              \u201cHer current observations are\u2026, she appears\u2026, and my assessment is\u2026\u201d<\/p>\n\n\n\n

              \n

              Clinical Tip – Keep It Relevant<\/h3>\n\n\n\n

              Ask yourself: \u201cDoes the receiving clinician need this information to understand the current situation or safely continue the patient’s care?\u201d<\/strong> If not, it may not need to be included in the verbal handover. Prioritise relevant history, risks, treatments, recent changes and significant results.<\/p>\n<\/div>\n\n\n\n

              6. A \u2014<\/code> Assessment<\/h2>\n\n\n\n

              The Assessment<\/strong> component communicates the patient\u2019s 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]<\/p>\n\n\n\n

              What to Include in Assessment<\/h3>\n\n\n\n
                \n
              • Vital signs and observations<\/strong><\/li>\n\n\n\n
              • Focused physical assessment findings<\/strong><\/li>\n\n\n\n
              • Changes from the patient’s baseline or previous observations<\/strong><\/li>\n\n\n\n
              • Pain<\/strong> or other significant symptoms<\/li>\n\n\n\n
              • Fluid balance<\/strong>, intake or output where relevant<\/li>\n\n\n\n
              • Level of consciousness or neurological changes<\/strong><\/li>\n\n\n\n
              • Relevant investigation results, if known<\/li>\n\n\n\n
              • Response to interventions or treatment<\/li>\n\n\n\n
              • Any other findings directly related to the current concern<\/li>\n<\/ul>\n\n\n\n

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

                \n

                Communicate Trends, Not Just Numbers<\/h3>\n\n\n\n

                A single observation provides information at one point in time. When available, compare current findings with previous observations to communicate whether the patient’s condition is stable, improving or deteriorating.<\/p>\n<\/div>\n\n\n\n

                For example:<\/p>\n\n\n\n

                Less informative:<\/strong> “Her respiratory rate is 24.”<\/p>\n\n\n\n

                More informative:<\/strong> “Her respiratory rate has increased from 18 to 24 breaths\/min.”<\/p>\n\n\n\n

                The second statement tells the receiving clinician that there has been a change<\/strong>, not merely what the current number is.<\/p>\n\n\n\n

                Example: Mrs Tolarni<\/h3>\n\n\n\n

                Let’s give our fictional patient a realistic set of educational example observations<\/strong>:<\/p>\n\n\n\n

                Assessment<\/th>Finding<\/th><\/tr><\/thead>
                Temperature<\/td>38.2\u00b0C<\/strong><\/td><\/tr>
                Heart rate<\/td>104 beats\/min<\/strong><\/td><\/tr>
                Blood pressure<\/td>102\/64 mmHg<\/strong><\/td><\/tr>
                Respiratory rate<\/td>24 breaths\/min<\/strong><\/td><\/tr>
                SpO\u2082<\/td>96% on room air<\/strong><\/td><\/tr>
                Neurological status<\/td>Increasing confusion compared with earlier assessment<\/td><\/tr>
                Oral intake<\/td>Reduced<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                \u201cOn assessment, Mrs Tolarni’s temperature is 38.2\u00b0C, heart rate 104 beats\/min, blood pressure 102\/64 mmHg, respiratory rate 24 breaths\/min and SpO\u2082 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.\u201d<\/p>\n\n\n\n

                Educational example:<\/strong> 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.<\/p>\n\n\n\n

                Assessment vs Diagnosis<\/h3>\n\n\n\n

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

                For example:<\/p>\n\n\n\n

                Avoid saying:<\/strong> “She is septic.”<\/p>\n\n\n\n

                unless this has been clinically established.<\/p>\n\n\n\n

                Preferable:<\/strong> \u201cShe has developed fever, tachycardia, increased respiratory rate and increasing confusion, and I’m concerned that her condition is deteriorating.\u201d<\/p>\n\n\n\n

                \n

                Clinical Tip – Be Specific<\/h3>\n\n\n\n

                Communicate what you assessed, what has changed and what concerns you.<\/strong> Relevant trends can be more informative than isolated numbers. Use objective clinical findings and clearly state your concern rather than relying on vague phrases such as \u201cthe patient doesn’t look right.\u201d<\/p>\n<\/div>\n\n\n\n

                7. R \u2014<\/code> Recommendation<\/h2>\n\n\n\n

                The Recommendation<\/strong> 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]<\/p>\n\n\n\n

                What to Include in Recommendation<\/h3>\n\n\n\n

                Depending on the clinical situation, the Recommendation may include:<\/p>\n\n\n\n

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

                  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.<\/p>\n\n\n\n

                  Be Clear About What You Need<\/h3>\n\n\n\n

                  Less effective:<\/strong> “That’s everything about Mrs Tolarni.”<\/p>\n\n\n\n

                  More effective:<\/strong> “I’m concerned about her deterioration and would like her reviewed promptly.”<\/p>\n\n\n\n

                  Less clear<\/th>More effective<\/th><\/tr><\/thead>
                  \u201cCan you have a look when you can?\u201d<\/td>\u201cI’m concerned about her deterioration and would like her reviewed promptly.\u201d<\/td><\/tr>
                  \u201cJust letting you know.\u201d<\/td>\u201cCould you please review her and advise on the next steps?”<\/td><\/tr>
                  \u201cWe’ll keep watching her.\u201d<\/td>\u201cWe will continue observations and reassess her while awaiting review.\u201d<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                  For a real patient, the urgency and escalation pathway should be determined using the patient’s condition and the healthcare service’s local criteria.<\/p>\n\n\n\n

                  Example: Mrs Tolarni<\/h3>\n\n\n\n

                  We established that Mrs Tolarni has:<\/p>\n\n\n\n

                    \n
                  • Increasing confusion and fatigue<\/li>\n\n\n\n
                  • Temperature 38.2\u00b0C<\/strong><\/li>\n\n\n\n
                  • HR 104 beats\/min<\/strong><\/li>\n\n\n\n
                  • BP 102\/64 mmHg<\/strong><\/li>\n\n\n\n
                  • RR 24 breaths\/min<\/strong><\/li>\n\n\n\n
                  • SpO\u2082 96% on room air<\/strong><\/li>\n\n\n\n
                  • Reduced oral intake<\/li>\n<\/ul>\n\n\n\n

                    For R \u2014 Recommendation<\/strong>, let’s use: \u201cI’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.\u201d<\/p>\n\n\n\n

                    Educational example:<\/strong> 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.<\/p>\n\n\n\n

                    Confirm the Plan<\/h3>\n\n\n\n

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

                    Before finishing, clarify:<\/p>\n\n\n\n

                      \n
                    • What happens next<\/strong><\/li>\n\n\n\n
                    • Who is responsible for the next action<\/li>\n\n\n\n
                    • Whether anything remains outstanding<\/li>\n\n\n\n
                    • Whether the receiving clinician has questions<\/li>\n\n\n\n
                    • That important information has been understood<\/li>\n<\/ul>\n\n\n\n
                      \n

                      Clinical Tip – Don’t End Without a Plan<\/h3>\n\n\n\n

                      A good ISBAR should leave the receiving clinician knowing what needs to happen next.<\/strong> Clearly communicate the required review, action or follow-up, confirm responsibilities where appropriate, and provide an opportunity for questions or clarification.<\/p>\n<\/div>\n\n\n\n

                      8. How to Prepare Before an ISBAR Handover<\/h2>\n\n\n\n

                      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]<\/p>\n\n\n\n

                      Before You Begin<\/h3>\n\n\n\n

                      Where appropriate, check the following:<\/p>\n\n\n\n

                        \n
                      • Confirm the patient’s identity<\/strong> using the healthcare service’s approved identifiers.<\/li>\n\n\n\n
                      • Review the reason for admission<\/strong> and relevant clinical history.<\/li>\n\n\n\n
                      • Check the latest vital signs and observations<\/strong>.<\/li>\n\n\n\n
                      • Review important changes or trends<\/strong> in the patient’s condition.<\/li>\n\n\n\n
                      • Review relevant assessment findings<\/strong>.<\/li>\n\n\n\n
                      • Check relevant medications and recent treatments<\/strong>.<\/li>\n\n\n\n
                      • Confirm allergies, alerts and clinical risks<\/strong>.<\/li>\n\n\n\n
                      • Review significant investigation or test results<\/strong>, where relevant.<\/li>\n\n\n\n
                      • Identify outstanding investigations, treatments or care tasks<\/strong>.<\/li>\n\n\n\n
                      • Consider the patient’s current goals and priorities of care<\/strong>, where relevant.<\/li>\n\n\n\n
                      • Identify anything requiring review, follow-up or escalation<\/strong>.<\/li>\n\n\n\n
                      • Organise the information into I\u2013S\u2013B\u2013A\u2013R<\/strong> before beginning the handover.<\/li>\n<\/ul>\n\n\n\n

                        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.<\/p>\n\n\n\n

                        Use the Most Current Information<\/h3>\n\n\n\n

                        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.<\/p>\n\n\n\n

                        Student Note: Do not rely on memory alone.<\/strong> 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.<\/p>\n\n\n\n

                        Minimise Interruptions Where Possible<\/h3>\n\n\n\n

                        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.<\/p>\n\n\n\n

                        Protect the patient’s privacy and confidentiality when discussing clinical information, particularly in shared or public areas.<\/p>\n\n\n\n

                        Prepare Your ISBAR<\/h3>\n\n\n\n
                        Before speaking, ask youself…<\/th>ISBAR<\/th><\/tr><\/thead>
                        Who am I and which patient am I discussing?<\/td>I \u2014<\/code> Identify \/ Introduction<\/td><\/tr>
                        What is happening right now?<\/td>S \u2014<\/code> Situation<\/td><\/tr>
                        What relevant information explains the situation?<\/td>B \u2014<\/code> Background<\/td><\/tr>
                        What have I assessed and what has changed?<\/td>A \u2014<\/code> Assessment<\/td><\/tr>
                        What needs to happen next?<\/td>R \u2014<\/code> Recommendation<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                        What if the Patient Is Deteriorating?<\/h3>\n\n\n\n

                        Preparation should not delay urgent assessment or escalation<\/strong>. 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.<\/p>\n\n\n\n

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                        Clinical Tip – Prepare, Then Prioritise<\/h3>\n\n\n\n

                        Prepare the information you need, but prioritise the patient’s immediate clinical needs.<\/strong> A well-prepared ISBAR should be accurate, current and relevant. In an urgent situation, do not delay escalation while trying to construct a perfect handover.<\/p>\n<\/div>\n\n\n\n

                        9. Complete ISBAR Handover Example – Mrs Ruby Tolarni<\/h2>\n\n\n\n

                        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.<\/p>\n\n\n\n

                        \n

                        Patient Scenario<\/h3>\n\n\n\n

                        Mrs Ruby Tolarni is a 70-year-old patient admitted with a urinary tract infection. She is receiving prescribed antibiotics and has had reduced oral intake. During the shift, she has become increasingly confused and fatigued compared with earlier assessments.<\/p>\n\n\n\n

                        I \u2014<\/code><\/strong> Identify \/ Introduction<\/strong><\/p>\n\n\n\n

                        \u201cHi, 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.\u201d<\/p>\n\n\n\n

                        Purpose:<\/strong> Establish who you are and ensure the correct patient is being discussed.<\/p>\n\n\n\n

                        S \u2014<\/code><\/strong> Situation<\/strong><\/p>\n\n\n\n

                        \u201cMrs 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.\u201d<\/p>\n\n\n\n

                        Purpose:<\/strong> Clearly communicate the immediate issue and why you are concerned.<\/p>\n\n\n\n

                        B \u2014<\/code><\/strong> Background<\/strong><\/p>\n\n\n\n

                        \u201cMrs Tolarni is receiving prescribed antibiotics for the urinary tract infection. Her oral intake has been reduced, and her confusion and fatigue have increased compared with earlier assessments.\u201d<\/p>\n\n\n\n

                        Purpose:<\/strong> Provide the relevant clinical context needed to understand the current situation.<\/p>\n\n\n\n

                        A \u2014<\/code><\/strong> Assessment<\/strong><\/p>\n\n\n\n

                        \u201cOn assessment, her temperature is 38.2\u00b0C, heart rate 104 beats\/min, blood pressure 102\/64 mmHg, respiratory rate 24 breaths\/min and SpO\u2082 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.\u201d<\/p>\n\n\n\n

                        Purpose:<\/strong> Communicate current objective findings, important changes and your clinical concern.<\/p>\n\n\n\n

                        R \u2014<\/code><\/strong> Recommendation<\/strong><\/p>\n\n\n\n

                        \u201cI’m concerned about Mrs Tolarni’s deterioration and 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.\u201d<\/p>\n\n\n\n

                        Purpose:<\/strong> Clearly state what assistance or action is required and what will happen next.<\/p>\n<\/div>\n\n\n\n

                        \n

                        Complete Handover: How It Sounds Together<\/h3>\n\n\n\n
                        \n

                        I:<\/strong> \u201cHi, 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.\u201d<\/p>\n\n\n\n

                        S:<\/strong> \u201cMrs 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.\u201d<\/p>\n\n\n\n

                        B:<\/strong> \u201cShe is receiving prescribed antibiotics for the urinary tract infection. Her oral intake has been reduced, and her confusion and fatigue have increased compared with earlier assessments.\u201d<\/p>\n\n\n\n

                        A:<\/strong> \u201cOn assessment, her temperature is 38.2\u00b0C, heart rate 104 beats\/min, blood pressure 102\/64 mmHg, respiratory rate 24 breaths\/min and SpO\u2082 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.\u201d<\/p>\n\n\n\n

                        R:<\/strong> \u201cI 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.\u201d<\/p>\n<\/blockquote>\n<\/div>\n\n\n\n

                        Educational example:<\/strong> 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.<\/p>\n\n\n\n

                        10. Common ISBAR Mistakes to Avoid<\/h2>\n\n\n\n

                        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]<\/p>\n\n\n\n

                        Common Mistakes<\/h3>\n\n\n\n
                        Common mistake<\/th>Why it matters<\/th>Better approach<\/th><\/tr><\/thead>
                        Not correctly identifying the patient<\/td>Creates a risk of information being associated with the wrong patient<\/td>Follow the healthcare service’s approved patient-identification process<\/td><\/tr>
                        Giving a long Situation<\/td>The immediate concern can become unclear<\/td>State the current problem and reason for communication early<\/td><\/tr>
                        Providing too much Background<\/td>Important information may become buried among irrelevant details<\/td>Include background relevant to the current situation and ongoing care<\/td><\/tr>
                        Reading the entire chart<\/td>Does not prioritise what the receiving clinician needs to know<\/td>Select current, clinically relevant information<\/td><\/tr>
                        Reporting numbers without context<\/td>Isolated observations may not show whether the patient’s condition has changed<\/td>Communicate important trends and changes from baseline where available<\/td><\/tr>
                        Using vague language<\/td>Phrases such as \u201cnot looking good\u201d provide limited clinical information<\/td>Describe objective findings and clearly state your clinical concern<\/td><\/tr>
                        Presenting an assumption as a diagnosis<\/td>May communicate an unconfirmed conclusion as fact<\/td>Report your findings and concern, and distinguish them from an established diagnosis<\/td><\/tr>
                        Leaving out the Recommendation<\/td>The receiving clinician may not know what action or follow-up is required<\/td>Clearly state what review, action or ongoing care is needed<\/td><\/tr>
                        Not clarifying responsibility<\/td>Tasks or follow-up may be missed<\/td>Confirm the ongoing plan and who is responsible where appropriate<\/td><\/tr>
                        Not allowing questions<\/td>Misunderstandings or missing information may remain unresolved<\/td>Provide an opportunity for questions and clarification<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                        Avoid Information Overload<\/h3>\n\n\n\n

                        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.<\/p>\n\n\n\n

                        Relevant does not mean everything you know about the patient. It means what the receiving clinician needs to safely continue care.<\/strong><\/p>\n\n\n\n

                        Avoid Vague Clinical Language<\/h3>\n\n\n\n
                        Instead of saying…<\/th>Communicate more specifically…<\/th><\/tr><\/thead>
                        \u201cShe doesn’t look right.\u201d<\/td>\u201cShe is increasingly confused compared with my earlier assessment.\u201d<\/td><\/tr>
                        \u201cHer observations aren’t good.\u201d<\/td>\u201cHer respiratory rate has increased from 18 to 24 breaths\/min.\u201d<\/td><\/tr>
                        \u201cShe’s not eating much.\u201d<\/td>\u201cHer oral intake has been reduced during this shift.\u201d<\/td><\/tr>
                        \u201cCan someone look at her?\u201d<\/td>\u201cI’m concerned about her deterioration and would like her reviewed promptly.\u201d<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

                        Objective information makes the concern easier for the receiving clinician to understand. However, clinical concern itself is also important\u2014if you are worried about a patient, communicate that concern clearly.<\/p>\n\n\n\n

                        Don’t Diagnose Beyond What You Know<\/h3>\n\n\n\n

                        ISBAR should distinguish between established information, assessment findings and clinical concern<\/strong>. Avoid presenting an unconfirmed diagnosis as fact.<\/p>\n\n\n\n

                        For our Mrs Tolarni example:<\/p>\n\n\n\n

                        Avoid saying:<\/strong> \u201cMrs Tolarni is septic.\u201d<\/p>\n\n\n\n

                        unless this has been clinically established.<\/p>\n\n\n\n

                        Preferable:<\/strong> \u201cMrs Tolarni has developed fever, tachycardia, an increased respiratory rate and worsening confusion. I’m concerned that her clinical condition is deteriorating.\u201d<\/p>\n\n\n\n

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                        Clinical Tip – Clear, Relevant and Actionable<\/h3>\n\n\n\n

                        A useful ISBAR is not necessarily the longest one.<\/strong> Aim for communication that is accurate, current, relevant and clear about what needs to happen next. Adapt the level of detail to the patient, the type of handover and the urgency of the clinical situation.<\/p>\n<\/div>\n\n\n\n

                        11. ISBAR Documentation & Safety Considerations<\/h2>\n\n\n\n

                        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]<\/p>\n\n\n\n

                        Document Important Information<\/h3>\n\n\n\n

                        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]<\/p>\n\n\n\n

                        Good clinical documentation should be:<\/strong><\/p>\n\n\n\n