Medication and Teaching
Why Handoffs Matter
At shift change, the risk is not simply that a fact is forgotten.
At shift change, the risk is not simply that a fact is forgotten. The receiving nurse is taking on the authority and responsibility to act on the patient's current needs. A handoff therefore transfers information together with accountability; a message that lists facts but leaves ownership unclear is incomplete. SBAR is one way to make the message predictable: Situation states what is happening now; Background supplies relevant context; Assessment states what the communicator believes the problem may be; and Recommendation/Request identifies the action, response, or clarification being sought. SBAR structures communication. It does not authorize an LVN/LPN to diagnose independently, change a treatment plan, or give an order. Handoffs are safest when they occur face-to-face when feasible, with minimal interruptions, and as a two-way exchange. The receiving nurse asks questions, checks the record, and summarizes the plan before accepting responsibility. During bedside shift report, invite the patient and an appropriate family member to identify inaccuracies and raise concerns while the incoming nurse is present.