General Nursing (RGN)
HANDING OVER A WARD
Handing over a ward is a structured transfer of responsibility and relevant information from the outgoing to the incoming nursing team. It combines a concise report with record review, safety checks, controlled-drug accountability, patient involvement where appropriate, and clear escalation of outstanding care.
Purpose
- Maintain continuity and safety of patient care
- Transfer accountability and outstanding tasks
- Communicate changes, risks, and priorities
- Protect confidentiality and support teamwork
Indications
- Every planned change of shift
- Transfer of responsibility during an urgent staffing change
- A ward or team handover required by facility policy
Equipment
- Ward state or census
- Patient folders or approved electronic record
- Observation and treatment charts
- Nurses’ report or handover book
- Care plans and risk assessment tools
- Controlled-drug register and key according to policy
- Equipment and maintenance records
Preparation
- Update notes and care plans before handover and verify that verbal information matches the record.
- Identify patients needing direct bedside review, senior review, or immediate safety action.
Procedure steps
- Prepare the handover in advance by reviewing each patient, outstanding results, observations, medications, risks, and planned care.
- Use a quiet, secure area and share only information needed for care; protect records and electronic screens.
- Welcome the incoming nurse and give a structured patient-by-patient report, prioritizing unstable patients, deterioration, allergies, risks, and time-critical actions.
- State what has been completed, what is due, what has changed, and who has been informed; avoid assumptions and invite questions.
- Review charts, notes, orders, observation trends, fluid balance, devices, and care plans together.
- Conduct a bedside safety check where appropriate, confirming identity, patient condition, oxygen, infusions, drains, wounds, pressure areas, and immediate needs.
- Involve the patient respectfully when suitable and avoid discussing confidential details where others can hear.
- Count and hand over controlled medicines, keys, equipment, specimens, and ward resources according to policy.
- Inspect the ward environment, report hazards or defective equipment, and record unresolved maintenance or staffing issues.
- Confirm that the incoming nurse accepts responsibility, document the handover and outstanding actions, and escalate any unresolved safety concern before leaving.
Precautions
- Use a structured format such as SBAR or the facility’s approved tool and focus on clinically relevant facts.
- Do not leave a deteriorating patient, critical infusion, or time-critical task without explicit transfer and escalation.
- Maintain confidentiality during bedside and electronic handover.
- Controlled-drug counts and keys must follow local policy and be signed by authorized staff.
Documentation
- Record the handover time, staff involved, significant changes, outstanding tasks, controlled-drug count, and escalations.
- Document any refusal, unresolved defect, or transfer of responsibility according to policy.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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