nursing-shift-handover

name: nursing-shift-handoverdescription: "Write a nursing shift handover for a ward, unit or community caseload in ISBAR order, patient by patient, with the sickest first, outstanding tasks timed and owned, and the risks the next shift must watch. Use when asked to write my handover, structure a shift report, prepare bedside handover notes, hand over my patients, or tidy these handover notes. Produces a prioritised handover sheet per patient, a ward-level watch list, and a list of tasks due in the next shift. Distinct from clinical-case-summary, which presents one case in depth."version: 1.0.0

Nursing Shift Handover

Handover is where information is lost: a pending result nobody chases, a new allergy mentioned once, a patient who was "a bit off" at 05:00. This skill turns a nurse's notes into a handover the next shift can act on in the order that matters. It supports documentation. It does not make clinical decisions, and the nurse giving handover remains accountable for its accuracy.

What This Skill Produces

• A handover entry per patient in ISBAR order (Identify, Situation, Background, Assessment, Recommendation)
• Patients ordered by clinical concern, not bed number, with the reason for the order stated
• A task list for the incoming shift with a time and an owner for each item
• A ward-level watch list: falls risk, deteriorating scores, infection control, safeguarding, staffing gaps
• A read-back line for anything that must be confirmed verbally

Required Inputs

Ask for these if not provided. Do not invent observations, scores or drug names.

• Setting and shift: ward or unit type, shift ending, number of patients
• For each patient: bed or identifier, age band, reason for admission, key history, allergies
• Latest observations and early warning score with the time taken, and the trend
• What changed this shift: new orders, procedures, falls, family concerns, mood or behaviour
• Outstanding items: results awaited, reviews requested, medicines due, fluid balance, wound care, discharge steps
• Escalations already made, to whom, and the response
• Local handover format if the organisation mandates one (follow it over this template)

Remind the user once: use bed numbers or initials unless their organisation has approved this tool for identifiable patient data.

Framework: ISBAR With a Priority Sort

1. Sort first. Order patients: (a) deteriorating or escalated, (b) new admissions and post-procedure, (c) high-risk medicines, infusions or monitoring, (d) discharge today, (e) stable.
2. Identify. Bed, age band, admitting team, resuscitation status and allergies in one line.
3. Situation. Why they are here and the one thing that matters most right now.
4. Background. Only history that changes care this shift.
5. Assessment. Observations with times, score and trend, pain, intake and output, skin, mobility, mental state. Report what was measured, then what the nurse thinks.
6. Recommendation. What the next shift must do, by when, and what would trigger escalation.
7. Close the loop. Every outstanding item gets a time and an owner. "Chase bloods" is not a task; "potassium result due 20:00, call the on-call doctor if above the range the team set" is.

Output Format

Handover: [ward], [shift] to [shift], [date]

Watch list: [patients of concern and why, in one line each]

Bed [x] ([age band], [team], allergies: [list or none known], resus status: [as documented])

• S: [situation]
• B: [relevant background]
• A: obs at [time]: [values], score [n], trend [up / down / stable]. [Other findings.]
• R: [action] by [time], owner [role]. Escalate if [trigger].
• Read back: [item to confirm verbally, if any]

Due next shift

Ward-level: [staffing, bed moves, equipment, infection control, safeguarding]

Assumptions and gaps

• [What was assumed because the notes did not say]
• [The missing information that would most change this handover]

Prepared from the notes supplied. The handing-over nurse checks every entry against the record before use.

Quality Checks

• Patients are ordered by concern and the reason for the order is written down
• Every observation has a time, and scores show a trend
• Every outstanding task has a time and an owner
• Allergies and resuscitation status appear for every patient, or are marked "not supplied"
• No value, drug or dose appears that was not in the input
• Escalation triggers are stated for patients of concern

Anti-Patterns

• Do not order by bed number. The sickest patient goes first.
• Do not write "stable" without the observations that support it.
• Do not fill gaps. A missing score is written as missing.
• Do not include the whole history. Only what changes care this shift.
• Do not give clinical advice. Record the plan the team has set and the trigger to escalate.

Example Trigger Phrases

• "Turn these scribbled notes into an ISBAR handover for the night shift."
• "I have eight patients. Help me hand over the two I am worried about first."
• "Write a bedside handover sheet from this list of beds and jobs."
• "What is still outstanding for the next shift from these notes?"

Run this skill in your browser: https://mohitagw15856.github.io/pm-claude-skills/skill/nursing-shift-handover.html