Patient Hand-Off (SBAR)

Joint Commission NPSG 02.05.01 standardized hand-off using SBAR framework (Situation, Background, Assessment, Recommendation). Used at shift change, transfer between units, or transfer to a different provider.

Steps

• Verify the hand-off trigger and patient identity
• State the current situation
  The outgoing role states the immediate reason for hand-off, current patient status, and any urgent concerns. Include the current location, active issues, and what requires attention next.
• Summarize relevant background
  The outgoing role provides concise background information that affects current care. Include diagnosis, pertinent history, recent procedures, allergies, isolation status, code status, and other relevant events. Exclude non-essential details.
• Report the current assessment
  The outgoing role communicates the latest assessment findings, vital trends, pain status, lines or drains, mobility limits, pending results, and any deviations from expected condition. State objective observations and current clinical concerns.
• Give clear recommendations
  The outgoing role states the next actions, monitoring priorities, time-sensitive tasks, escalation criteria, and any follow-up needed. Identify what must happen next and who to contact if the condition changes.
• Confirm closed-loop understanding
  The receiving role repeats back critical information, clarifies any ambiguity, and confirms responsibility for the patient. Resolve discrepancies before ending the hand-off.
• Document the hand-off and escalate exceptions
  The outgoing role documents the hand-off completion, key SBAR points, and any outstanding tasks in the approved record. If information is missing, the patient is unstable, or a safety concern exists, escalate to the charge nurse, supervisor, or responsible provider immediately.