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J Adv Nurs. 2018 Jul;74(7):1659-1671. doi: 10.1111/jan.13565. Epub 2018 Apr 6.

A Delphi study to identify the core components of nurse to nurse handoff.

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Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, IL, USA.
Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL, USA.
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birminfham, AL, USA.
University of Illinois at Chicago, Chicago, IL, USA.
Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA.



The aim of this study was to identify the core components of nurse-nurse handoffs.


Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified. This lack of identification is a significant gap in moving towards a standardized approach for nurse-nurse handoff.


Mixed methods design using the Delphi technique.


From May 2016 - October 2016, using a series of iterative steps, a panel of handoff experts gave feedback on the nurse-nurse handoff core components and the content in each component to be passed from one nurse to the next during a typical unit-based shift handoff. Consensus was defined as 80% agreement or higher.


After three rounds of participant review, 17 handoff experts with backgrounds in clinical nursing practice, academia and handoff research came to consensus on the core components of handoff: patient summary, action plan and nurse-nurse synthesis.


This is the first study to identify the core components of nurse-nurse handoff. Subsequent testing of the core components will involve evaluating the handoff approach in a simulated and then actual patient care environment. Our long-term goal is to improve patient safety outcomes by validating an evidence-based handoff framework and handoff curriculum for pre-licensure nursing programmes that strengthen the quality of their handoff communication as they enter clinical practice.


Delphi technique; communication; handoff; handover; nurses

[Indexed for MEDLINE]

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