General Nursing (RGN)
TAKING OVER A WARD
Taking over a ward is the incoming nurse’s systematic verification of patients, records, staff information, medicines, equipment, and environmental safety. It converts the outgoing report into an accountable assessment of the ward at the start of a shift.
Purpose
- Establish the current condition and priorities of every patient
- Identify risks and outstanding care at the beginning of duty
- Accept responsibility for medicines, equipment, records, and ward safety
- Promote continuity, communication, and accountability
Indications
- Beginning a morning, afternoon, or night duty
- Assumption of responsibility after staff redeployment
- Any formal transfer of ward responsibility
Equipment
- Ward census or state
- Patient folders or approved electronic record
- Observation, treatment, fluid-balance, and care-plan charts
- Handover or report book
- Controlled-drug register and key according to policy
- Equipment checklist and maintenance log
- Pen or approved electronic documentation system
Preparation
- Know the ward layout, emergency procedures, staffing allocation, and local escalation pathways.
- Prioritize unstable patients and time-critical treatments before routine administrative tasks.
Procedure steps
- Arrive on time, perform hand hygiene, and receive the outgoing nurse’s structured verbal report in a private area.
- Read the ward report and relevant patient records, confirming diagnoses, allergies, risks, recent observations, investigations, and outstanding actions.
- Clarify any discrepancy or incomplete information before accepting responsibility; use closed-loop communication.
- Conduct a bed-to-bed assessment with the outgoing nurse, identifying each patient with two identifiers and asking about immediate concerns.
- Check the patient’s general condition, airway and breathing support, consciousness, pain, skin and pressure areas, nutrition, elimination, mobility, and safeguarding needs.
- Verify oxygen, infusions, drains, catheters, feeding tubes, dressings, monitoring equipment, and alarms; confirm prescribed settings and patency.
- Review medicines due, allergies, controlled medicines, emergency equipment, stock, keys, and any medicine needing urgent action.
- Inspect the ward, utility areas, emergency exits, oxygen supply, suction, call bells, resuscitation equipment, cleanliness, and equipment defects.
- Record hazards, staffing concerns, missing resources, and unresolved clinical tasks; escalate urgent risks immediately.
- Sign or electronically confirm the handover only after understanding it, document the taking-over process, and begin the prioritized plan of care.
Precautions
- Never accept responsibility for an unclear or unsafe handover without escalating and recording the concern.
- Check actual patient and device status rather than relying only on verbal report.
- Protect confidentiality during bedside review and electronic record access.
- Controlled medicines, keys, and equipment must be counted and transferred according to facility policy.
Documentation
- Record handover time, staff involved, patient risks, outstanding tasks, counts, equipment faults, and escalations.
- Update the ward state and care plan when the assessment identifies a change.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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