Bedside Handover is a brief, structured shift report presented by the outgoing nurse to the oncoming nurse and the patient. It empowers the patient and the oncoming nurse to verify information being reported, to hear the status of nursing-sensitive quality and safety indicators, and to start the shift on the same page with the patient’s subjective goal – what the patient cares most about.

The Nurses First implementation of Bedside Handover elevates shift report from a task to an elite competency – with specific skills to learn, practice, and verify.

Bedside Handover usually takes 2-5 minutes per patient.

The Nurses First version of Bedside Handover is unique in a few ways. First, it’s user-friendly: it has a streamlined, front-and-back single page format using an ISBAR outline with a review of systems. Many thousands of nurses have refined this Bedside Handover for Nurses First. So, the information needed for continuity and safety flows in the same logical sequence every time. That’s super-important. When we hear information in the same predictable order every time, our brains can start making sense of the information right away (instead of having to do extra work just to figure out what information is coming at us and what’s most important).

Second, it’s always done at the bedside. Let’s face it, as nurses we sometimes shy away from doing handover with the patient. But if we’re at the bedside lots of positives happen at once. One positive is that we can visually assess our patients as we hear about them – it makes the story and the status come alive and creates a living picture of who the patient is right now. Another positive is the accountability it creates – it lets us verify information we’re hearing as we hear it.

Last, but not least, it gives the patient and family a chance to see us in a highly professional light. Their confidence in us grows. They notice when we invite their inputs. They hear us make accuracy a priority. And they feel greater control over their care and safety.

The Bedside Handover report is a pre-printed 1-page front-and-back sheet. It uses the familiar ISBAR format (Identity, Situation, Background, Assessment, Recommendation) with a review of systems to help build a picture of who this patient is right now and what needs to be done on the upcoming shift.

What’s special is it flows from top-to-bottom in a simple, logical way. It quickly becomes familiar after using it just a few times.

The structure lets us be brief and to the point. It lets us give and receive handover in the exact same sequence every time.

Before the launch of Bedside Handover, we will work with the nurses on each participating unit to smartly customize their version of the report to meet the needs of their unit and patient population.

Ideally, to listen, learn, and help verify that the information is accurate.

The art of Bedside Handover is to communicate accurate information that’s inherently complex and changing across at least three different people – you, your oncoming colleague, and the patient.

That’s hard.

To make it easier, friendlier, and more purposeful, we’ve pinpointed the 9 high-performance behaviors for doing bedside handover really well.

When an outgoing nurse consistently practices these 9 high-performance behaviors, it signifies competence.

Nurses First is designed to help us know exactly when we’ve achieved competence on our journey to becoming an expert in Bedside Handover. We’ve made it easy to assess these high-performance behaviors electronically with the 1Unit Software Platform.

Electronic skills assessments are unique and valuable. Electronic skills assessments help staff learn from real-time feedback. They also show staff we’re paying attention and can easily collect data about the integrity of the processes. Nurse Managers and executives can use this data to support individuals who are struggling, strengthen regular performance reviews, and sustain overall great performance.

Soon after the launch of the Nurses First processes, Nurse Managers and their assessors begin the process of assessing their nurses.

In this picture, two nurses are conducting a Bedside Handover. The third is a charge nurse who is in the role of an assessor. She is using the 1Unit software to conduct a real-time electronic skills assessment.

On the assessor’s device is a list of the 9 high-performance behaviors for Bedside Handover. They are tapping the boxes next to each high-performance behavior that the outgoing nurse is performing successfully while giving the Bedside Handover.

After the handover, the 3 nurses return to the hallway, and the assessor privately shows the outgoing nurse how they did – revealing any blind spots they may have. This feedback is real-time, objective, and specific. The outgoing nurse now knows exactly what to work on with the next patient.

When a score of at least 8-out-of-9 is earned for three different Bedside Handovers, the 1Unit Software Platform marks that nurse as ‘Competency Verified’.

Nurses should be re-verified at least once every 24 months.

One of the additional benefits of the Nurses First Bedside Handover process is that it ensures every nurse can start and end each shift ready to do any type of interdisciplinary rounds or advocate for any of their patients at any time during their shift. N1 Bedside Handover ensures review of a unit specific quality-safety checklist, containing common HACs, occurs at least twice every day to prevent unintentional harm and costs. Nurse colleagues can also easily step-in for each other if needed, as the pertinent patient information is readily available. Units with Nurses First have seen significant improvements in patient experience.