Clinical Handover

IENG 3108 English V

Week 4

Look at the picture. What are they

doing most likely?
A) They are discussing
the latest issues in
healthcare.
B) The woman explains to
the man about the
new machine.
C) The man gives reports
at patients bedside.
D) They are doing patient
endorsement.

Vocabulary
Shift a persons scheduled period of work.
AM Shift (morning shift) [7am-3pm or 8am 4pm]
PM Shift (afternoon shift) [3pm 11pm or 4pm 12 mn]
NOC shift [(nocturnal) night shift or grave yard shift)] [11
pm 7am or 12mn 8am]
Note: Some hospitals have only 2 shifts (e.g, AM (7am-7pm)
and PM (7pm to 7am)

 significant important
clinical impression initial diagnosis
as tolerated capability (power) to perform without
adverse reactions
facility health care unit (hospital, wards, or
departments)
healthcare provider (HCP) a person who gives care
to a patient (nurse, doctor, etc.)
frequency a number of times
duration length of time
assistance the action of helping someone with a
task or job

What are the corresponding English Term of the following?

Patient Handover/Clinical Handover/

Patient Endorsement/Shift Report
o Transfer of professional responsibility and
accountability for some or all aspects of care
for a patient or group of patients to another
person or professional group on a temporary
or permanent basis.
When the nurses shift duty ends or
When a patient has a change of facility of care
(within the hospital or to other facility)

What is the significance of clinical

handover?
To avoid adverse events caused by poor
communication:
Delay in diagnosis or treatment
Missed or duplicated tests
Wrong treatment
Medication error

What are the components of good

handover?
Information transferred should be
Significant
Accurate
Unambiguous (clear/specific)
Occur in a timely manner

Standardized format (ISBAR)

Adapted to reflect local need

When does clinical handover occur?

Teams

Episode
Ward rounds

Within a unit

Unit/Specialty Team
Unit/nurse or allied health
ED/ER/A&E and Ward

Ward / Discharge

Medical shift changes

(AM/PM/NOC)
Consultation (e.g., referring pt to
the attending physician)
At any specially consultation (e.g.,
code blue team)
On ward/by phone or written
referral
At any admission to ward or
discharge

At any discharge from hospital

Standard Framework

I
S
B
A
R

Introduction

Identify yourself (name, position, location [if on

phone referral], role and the patient (name, age,
sex, location)

Situation

State the pts chief complaint, diagnosis and

current problem

Background

Patients history significant to the problem and

clinical background or context (significant history,
exam/labs and results, treatment/management)

Assessment

Current problems, observations and treatments

Recommendation

Plans: pending requests and risks

What do you recommend or want the next nurse
to do? (Be clear about request and timeframe.)
(Note: The receiving nurse should repeat to
confirm what was heard.)

Listen and identify the ISBAR.

I

In 306; Mrs. Chiander, she is 86 y.o.

She was admitted today for dehydration and possible

gastroenteritis. Shes been vomiting and having diarrhea for 2 days.
She is complaining of nausea and abdominal pain, weakness and
loss of appetite, very tired.

We send stool sample this afternoon to check for bacteria and were
waiting for the results and the results of serum electrolyte labs.

Her vital signs 2 hours ago were BP-88/54, P-110, T 101.5. Her O2
sats were 96 on 2L nasal cannula, respirations were 22 and her pain
was in 5.

I gave her Tylenol 2 hours ago and is not due for 2 hours

1. How many days did the patient stay in the hospital?

A.
B.
C.
D.

O day
1 day
2 days
3 days

2. Which laboratory results the nurses are waiting?

A.
B.
C.
D.

Urine analysis
MRI
ECG
Blood analysis

3. Which of the following is true about the patient?

A.
B.
C.
D.

He has abnormal oxygenation.

He is for operation.
She is on oxygen.
She does not need pain medication.

Listen and Identify the ISBAR.

I

Mr. Kaiyan is a 28 y.o. male who came in 2 days ago

complaining of coughing and shortness of breath. He was later

diagnosed to have pneumonia.

He is Dr. Bruciadas patient under family medicine.

Hes alert and oriented times 3. his vital signs are stable. His lungs are
clear throughout all fields. He is 98% on room air. Sinus rhythm on
telemetry. His heart rate runs in the 80s. Mr. Kaiyan gets up and goes to
the restroom independently. He has no complaints of nausea and
vomiting. Bowel sounds are present throughout all 4 quadrants. He
voids clear yellow urine. He is tolerating his regular diet, just fine. His
skin is intact. He has no complains of pain at this time. He does have a
20-gauge on his right forearm but has a normal saline right in at a
hundred milliliters per hour. His night was completely uneventful. He is
presently right now watching television in his bed quietly.

(Not mentioned in the audio.)

1.

Which ward is the patient now most likely?

A.
B.
C.
D.

2.

Medical
Surgical
Geriatrics
Pediatrics

Which of the following is most significant to be included in patients

background?
A.
B.
C.
D.

Fluid intake
Smoking intake
Alcohol intake
Diet and exercise

3. Which of the following statements best describe the patient?

A.
B.
C.
D.

The patient has fluids in the lungs.

The patient has on going blood transfusion.
The patient needs close monitoring.
The patient was able to sleep comfortably last night.

Present Simple and Past Simple

Present simple
- Actions happening or
not happening NOW.
- Subject + V1 + Object

Example:
Mr. Kaiyan is 28 years old.
His vital signs are stable.
His heart rate runs in the 80s.
He has no complaints of pain.

Past simple
Actions that started and
finished at a specific
time in the past.
Subject + V2 + Object
Example:
He came in 2 days ago.
His night was completely
uneventful.
Her O2 sats were 96 on 2L
nasal cannula

Situation: You are going to endorse your patient

to the incoming nurse. Your patient was
admitted 4 hours ago due to right lower
quadrant pain. The patient is scheduled for
operation at 4pm.
Questions:
1. What shift are you on duty?
2. What is the possible diagnosis of the patient?
3. What information (ISBAR) you should include in
your endorsement? (Think of the possible
significant information of the patients case. Use
present simple and past simple tense.)

Writing/Speaking: Choose a partner. Select a patients case and

prepare the significant information for endorsement.
Write in A4 using the kardex format. Endorse to the
incoming nurse on duty using the ISBAR format.