Nursing Practice Today

Volume 7, No 4, October 2020, pp. 266-274

Tehran University of Medical Sciences

Original Article

The impact of using “ISBAR” standard checklist on nursing clinical handoff in coronary
care units
Behrouz Pakcheshm1, Imane Bagheri2, Zohreh Kalani3*
1
Department of Critical Care Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2
Department of Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
3
Department of Nursing, Nursing and Midwifery Care Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

ARTICLE INFO ABSTRACT

Received 24 November 2019 Background & Aim: Clinical handoff is the process of transmitting information,
Accepted 29 February 2020 responsibility, and accountability among the health care team members. Lack of standard
protocols may result in the loss of essential information and may lead to medical errors. The
purpose of this study was to evaluate the impact of using a standard checklist on a clinical
Available online at: handoff in the coronary care unit.
http://npt.tums.ac.ir Methods & Materials: This quasi-experimental study was performed based on pre- and
post-test design at Afshar Hospital in Yazd. There was a total of 564 handoffs with the
participation of 24 nurses in two coronary care units in 2017. Before the intervention, 282
Key words: clinical handoffs were recorded and implemented. Nurses were informed about the ISBAR
nurses; standard checklist and were encouraged to use it for one week. Then, 282 clinical handoffs
coronary care unit; were again recorded and implemented. The frequency of providing information during
ISBAR, clinical handoff was determined based on the ISBAR checklist and the data were analyzed
patient handoff using descriptive statistics and chi-square tests.
Results: Before the intervention, the frequency of providing information during clinical
handoff was reported as follows: patient identity (86.9%), current position (75.1%), clinical
history (52.8%), system status review (59.9%), and recommendations (92.9%). The results
showed that the indexes significantly increased (P <0.001) after the intervention in all these
five domains: patient identity (100%), current situation (94%), clinical history (80.1%),
system status review (92.2%) and recommendations (100%).
Conclusion: Transition of information based on standard checklists with a specific
framework can increase the frequency of information provided during clinical handoff.
Therefore, it is recommended to train nurses and nursing students about standard handoff and
related tools such as ISBAR in hospitals and universities.

Introduction1 diagnosis, hemodynamic status as well as a

care plan, medical changes, and any patient-
Clinical handoff is a process of related changes (4). The correct transition of
transmitting information, responsibility, and information is a crucial component of
accountability among healthcare team maintaining safe patient care in the health
members and is an important part of the care system (5), which is known as one of
patient care process (1). Clinical handoff is the five priorities for improving patients’
regularly performed in the health sector, safety worldwide (6). Clinical handoff has
especially during shift deliveries, at least 2-3 provided improved nursing care including
times a day (2). It is a long-standing tradition enhanced patient care prioritization (4),
among nurses and its proper and standard increased transmission of patients’
practice provides safe care (3) and includes information to nurses and vice versa (1),
information about patients including disease increased documentation (4), reduced
overtime, decreased misunderstandings (1),
and increased productivity and group works
*Corresponding Author: Zohreh Kalani, Postal Address: Department of (4). Herawati states that good clinical
Nursing, Nursing and Midwifery Care Research Center, School of handoff helps identify errors and facilitate
Nursing and Midwifery, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran. E-mail: [email protected] continuity of patient care (7).
DOI: https://doi.org/10.18502/npt.v7i4.4036

Please cite this article as: Pakcheshm B, Bagheri I, Kalani Z. The impact of using “ISBAR” standard checklist on nursing clinical handoff in
coronary care units. Nursing Practice Today. 2020; 7(4):266-274
 B. Pakcheshm et al.

However, lack of communication among recommendations (R). They are easy to use
nurses in handover process has been and to remember. This checklist helps
identified as an important factor in reduced improve communications by proposing an
safety and quality of services and patient expected pattern of information to be
dissatisfaction (8), accounting for 80% of delivered at handoff and by identifying
serious health errors and 20% of adverse errors and omissions (18). In Iran, however,
complications in patients (9). Incomplete the clinical handoff is usually done verbally
handoff may increase the risk of adverse using kardex and is not based on an
complications due to the lack of an exchange integrated and structured protocol (5).
of information on essential components of Meanwhile, reviewing the literature suggests
patient care such as initial diagnosis, current that there is a need to develop a
treatment, and newly prescribed medication comprehensive and practical standard
(10). Adverse complications and risks to protocol for shift handoff (19) and most
patient safety can be the result of ineffective nurses are in favor of structured clinical
handoffs (1). On the other hand, given handoff (20). A review of literature outside
specific ward conditions, patient transfers Iran showed that using this checklist has led
and shift deliveries in intensive care units to the reduction of treatment errors (13, 16),
require constant monitoring of patients (11), reduction of incomplete information (16),
because of impaired the communication in provision of comprehensive and structured
these patients, they can be more vulnerable information (20), improved patient safety
(12). Imperfect communication during (13, 16), improved collaboration and
clinical handoff can lead to further communication among nurses (15, 20, 21),
complications in hospitals, and this is increased confidence (15) and health team
particularly more troublesome in intensive dynamics (21), increase in the ability of
care units with highly vulnerable patients nurses to manage clinical handoffs (7),
(13). The patients’ clinical handoff is done increase in the frequency and quality of the
using verbal reports, face to face reports, information provided (22, 23), and reduction
written reports, mobile phones, voice of the handoff time (22).
recordings, electronic reports and printouts, A few studies in Iran and the world have
and special forms. A structured either merely described the status quo (24,
communication tool would be beneficial to 25) or have examined the role of educational
effectively communicate the patient intervention on clinical handoff among the
information, reduce the adverse events, medical staff (18, 26). Some studies also
promote patient safety, improve the quality implemented alternative tools to evaluate the
of care, increase health care provider effects of educational interventions on
satisfaction (14), increase confidence among nurses’ performance (5). Therefore, the
caregivers (15), reduced medical and purpose of this study was to determine the
technical errors, and it can also help avoid effect of education using a structured tool,
losing critical information (16). ISBAR, during clinical handoff on the status
In recent decades, several measures have of the provided information.
been used to improve communications
during clinical handoff (9). SBAR and its Methods
derivatives (ISBAR, ISOBAR, and
This study is a quasi-experimental study
ISOBARR) are among the standard tools
that was conducted according to pre- and
recommended for clinical handoff of (2)
post-intervention research design in Afshar
which are recommended by the WHO and
Hospital of Yazd from October to December
the Joint Commission on Health Care for
in 2017. Prior to the intervention, for one
clinical handoff of patients (17). These tools
week, all the clinical handoffs in the
include patient’s current situation (S),
morning, evening, and night shifts were
patients’ clinical background (B), system
recorded in keeping with the ISBAR
status assessment (A), and necessary

Nursing Practice Today. 2020;7(4):266-274 267

Using “ISBAR” checklist on nursing handoff

standard checklist. One week after the the checklist addresses the patient’s
intervention, the nurses were given a 90- diagnosis and the situation at admission,
minute instructional session on how to use the patient's medical background, the test
the checklist and other necessary training. response, and other clinical procedures.
The training session was held in two Finally, the priorities of the nurses while
separate days to allow all the nurses to handoff and the specific treatment that
participate. The nurses were provided with should be provided, urgently, or as early as
the ISBAR checklist to use during the possible are addressed (28). For the
transition of the patient to the following present study, this checklist has been
nursing team. ISBAR Checklist posters translated into Farsi and has been modified
were also available at different wards to based on the opinions of 8 nursing faculty
answer the nurses’ questions on how to use members of Yazd College of Nursing and
the ISBAR checklist. Then, all the clinical Midwifery. The validity and reliability of
handoffs were recorded for another week. the checklist were determined,
Sampling time (one week) was consequently.
estimated based on the determined sample While conducting the study,
size using the formula designed for two demographic information questionnaires
dependent variables (two-way test). A were completed after cooperating with the
sample size of 282 clinical handoffs was head nurses of each department and the
recommended assuming at least 12% supervisors of each shift and obtaining
change after intervention, 95% level of informed consent from the nurses to
confidence, and 80% test power. participate in the research and to allow
Considering the number of beds in the two recording their voice during the shift
CCU wards at the study setting (14 beds handoff. The recorded files were
on aggregate) and the whole sampling evaluated, simultaneously, by two people
method in which all clinical handoffs in and were calculated based on the
the morning, evening, and night shifts frequency distribution checklist of each
were included, it was necessary to take domain and the related items. Generally, at
into account one week for data collection. least half of the dimensions of each
Inclusion criteria suggest clinical criterion were specified to determine the
handoffs that were completely delivered information provided in each domain.
by the supervisor at the patient’s bedside Prior to conducting the study, the
and the handoff where the nurses have proposal was approved by the Ethics
given their consent for the audio Committee in Research at Shahid
recordings. In case the patients would feel Sadoughi University of Medical Sciences
sick or the physicians could not finish their of Yazd as IR.SSU.REC.1396.180. This
checkups during the handoffs, they would study was also registered at the Iranian
be excluded from this study. Clinical Trials Registration Center as
The ISBAR checklist used by Spooner IRCT20181211041925N1.
and Thompson (18, 27) includes 5 areas The data were then analyzed using
and 16 items. Checklists include 4 items in SPSS software version 16 and based on
the domains of patient’s identity (I), descriptive statistics (mean and standard
patient’s current situation (S), and deviation) and referential statistics (chi-
patient’s clinical background (B); but, square).
include 2 items in the domains of
assessment (A) and necessary Results
recommendations (R). At first, the ISBAR
checklist helps identify the patients and 24 nurses in two CCU wards
introduce them to the nurses and then participated in this study from the
clarify the current distressing situation and beginning to the end. Most of the nurses
serious and urgent problems. After that, (70.8%) were female and the average age

268 Nursing Practice Today. 2020;7(4):266-274

 B. Pakcheshm et al.

of the nurses was 33.8±7.63. Almost half the implementation of interventions.

of the nurses belonged to the 30-39 years (Table 2)
old group (45.8%). (Table 1) Pertaining to the domain of the patient’s
On aggregate, 564 clinical handoffs clinical background (B), the provision of
were recorded before and after the information increased from 52.8% to
intervention in both wards and the data 80.1% (P<0.001). In addition, there was a
were analyzed against the ISBAR significant increase in all the items
checklist. including current disease background,
medicine background, surgical
The frequency of information provided
background, and major previous events
in clinical handoff in the domain of the
(P<0.001). (Table 2)
patient’s identity (I) increased from 86.9%
Providing information on system
to 100%; according to Fisher’s accurate
assessment (A) has also increased from
test, this is a significant difference
59.9% to 92.2% (P <0.001) and the results
(p<0.001). There were also significant
of the assessment of the systems and the
differences in the three items of name, age,
actions taken to resolve the problems have
and date of admission, but there was no
also increased significantly (P <0.001) in
significant difference in the diagnosis
the two items. (Table 2)
item. (Table 2)
In the domain of recommendations (R),
In the domain of the current situation the information provided in handoff has
(S), the information provided in handoffs also increased from 92.9% to 100%
increased from 75.1% to 94% (P<0.001). (P<0.001). There was a significant
Moreover, in this domain, there was a increase in the items regarding ongoing
significant increase in the three items of actions and the need for monitoring
probable resuscitation, the patient’s (P<0.001); yet, there was no significant
stability, and current symptoms and increase observed in the items about plans
problems (P <0.001). But there was an and follow-up measures in the next shifts.
insignificant decrease in the item regarding (Table 2).

Table 1. Demographic information of participant nurses

Variable N %

Female 17 70.8
Sex
Male 7 29.2
< 30 7 29.2
Age 30 – 39 11 45.8
≥40 6 25
Fixed 3 12.5
Shift
Rotation 21 87.5
Graduated 21 87.5
Educational degree
Master’s degree 3 12.5
< 10 years 10 41.7
Work experience 10 – 19 years 9 37.5
≥ 20 years 5 20.8

Nursing Practice Today. 2020;7(4):266-274 269

Using “ISBAR” checklist on nursing handoff

Table 2. The frequency of provided information among the five domains in clinical handovers before and after the intervention

Pre-intervention Post-intervention
Domains Items P-value
N % N %
Patient name 219 77.7 251 89 <0.001*
Patient age 41 14.5 246 81.2 <0.001*
Diagnosis 236 83.7 247 87.6 0.187*
Patient identity
Admission date 158 56 252 89.4 <0.001*
General provision of <0.001*
254 86.9 282 100
information *
Current observations 199 70.6 246 87.2 <0.001*
Implemented interventions 240 85.1 223 79.1 0.062*
Patient stability 105 37.2 217 77 <0.001*
Current situation
Probable resuscitation 22 7.8 138 48.9 <0.001*
General provision of
212 75.1 265 94 <0.001*
information
Current disease background 117 41.5 240 85.1 <0.001*
Medicine background 48 17 195 69.1 <0.001*
Surgical background 16 7.5 85 30.1 <0.001*
Clinical background
Major previous events 56 19.9 136 48.2 <0.001*
General provision of
149 52.8 226 80.1 <0.001*
information
Assessment of systems 160 56.7 244 86.5 <0.001*
Implemented measures to
139 49.3 237 84 <0.001*
System assessment obviate the problems
General provision of
169 59.9 260 92.2 <0.001*
information
Ongoing measures 217 77 246 87.2 <0.001*
Preventable plans and
237 84 238 84.4 0.908*
Recommendations measures
General provision of
262 92.9 282 100 <0.001*
information
*Chi-Square **Fishers’ exact test

Discussion
In this study, the information in clinical inappropriate treatment for the patient (30).
handoffs in 5 domains (patient identity, In this domain, there was a significant
patient current situation, patient clinical difference in the frequency of information
background, system assessment, and provided in handoff after intervention in all
recommendations) comprising of a total of the items except for the diagnosis of the
16 items was investigated against the disease. Given the frequency of over 80% in
ISBAR checklist. clinical diagnosis in clinical handoffs before
In the domain of patient identity, the and after the intervention, it seems that
information provided in handoff has nurses have always highlighted stating the
increased to 100% after the intervention and patient’s diagnosis.
the admission date and the patient’s name In addition, Fahim Yeganeh et al.
were the most frequent items within this conducted a study on transmitting clinical
domain after the intervention. Addressing information between the nurses in the
the patients by their name is one of the emergency measures ward and the assistants
important factors in the patient-nurse in the emergency room among patients with
relationship (29). Identifying the patient is trauma. They reported that the use of ISBAR
considered as one of the indicators of patient has helped improve the transmission of
safety and any errors in identifying the clinical information in handoffs by medical
patient (wrong patient error) are crucial staff (26). Accordingly, it seems that nurses
which may lead to consequences such as pay very little attention to the patients’ age
giving the wrong medicine to the patient, during clinical handoffs (14.5%). However,
performing the wrong treatment, providing a significant increase was observed after the
the wrong diagnosis and receiving nurses were accustomed to the standard

270 Nursing Practice Today. 2020;7(4):266-274

 B. Pakcheshm et al.

checklists. Thomson et al. conducted a study There was also a significant increase in
entitled "Using the ISBAR Tool in Clinical paying more attention to the patients’
Medical Handoff" and reported different clinical background in clinical handoffs after
results on this domain compared to the the intervention. The background of the
present study. The implementation of the current disease was the most frequent items
ISBAR tool in clinical handoff by before and after the intervention. The
physicians had no significant effect on frequency of provided information
emphasizing the patient’s age and name and significantly increased for all the items after
the medical diagnosis. Paying attention to the intervention. Therefore, it can be
the information regarding patient’s identity concluded that, prior to the intervention, the
in clinical handoffs in advanced countries least attention was paid to the patients’
like Australia, as it can be concluded from clinical background in the clinical handoff.
Thomson et al.’s study, is considered as a The findings showed a significant
routine even without the use of specific increase in the two domains of system
tools. Nevertheless, implementing ISBAR assessment and recommendations, each
can generally enhance the information containing two items, in clinical handoffs.
provided in clinical handoffs (18). Considering the nearly 40% increase in
system assessment, it seems that the nurses
Pertinent to the domain of the present have not given proper attention to systems
situation, there was a significant increase in assessment in this domain prior to the
the frequency of information provided after introduction of the standard content of
the intervention in all the items except for clinical handoffs. It can also be concluded
the “implemented interventions”. Nurses that nurses did not understand the
have always highlighted the frequency of importance and necessity of this domain
information provided in “implemented before being familiar with the respective
interventions” and the respective score was items. This is in line with the results of the
high even before the intervention (85.1%). study by Beyg Moradi et al., which showed
The sources of nursing principles and that nurses paid the least attention to system
techniques have always emphasized that the assessment during a clinical handoff in
nurse must obtain necessary information general wards (31). Meanwhile, a high
about the patients’ health status and their percentage of information provided in
general and specific problems in order to recommendations, even before the
develop an appropriate care plan (29). In this intervention, indicates that nurses have
regard, the results of the present study are in always highlighted this issue. This is in line
line with the results of another study with the study by Fahim Yeganeh et al (26)
conducted by Fahim Yeganeh et al., and the other by Acherkar et al (24), but it is
indicating that using the ISBAR tool can inconsistent with the results of Thomson et
increase the items provided in this domain al.’s study.
(26). The results of the present study are also Overall, the results indicated a dramatic
consistent with the results of a study by increase in the provided information among
Acherkar et al., who conducted a all the five domains of the checklists. This is
prospective study entitled "Introducing consistent with the results of Sandus’ study
SBAR to Clinical Nurses". Accordingly, on the impact of using this checklist on the
improvement of clinical handoff after the frequency of provided information based on
introduction of this tool was observed in all nurses' and midwives’ self-assessment (25).
the SBAR domains (24). However, The present study is one of the pioneering
Thomson et al. have reported different studies to evaluate and introduce a standard
results showing that the use of the SBAR tool for safe and systematic clinical handoff
tool did not significantly improve the in order to prevent from providing essential
provision of information about the patient’s information and exchanging unnecessary
current problem (18). information to nurses so as to improve the

Nursing Practice Today. 2020;7(4):266-274 271

Using “ISBAR” checklist on nursing handoff

quality of clinical handoffs. This is Acknowledgments

considered as one of the strengths of the
present study. One of the main executive The present study is part of a Master's
problems with this study was the staff’s Degree in Critical Care Nursing in the
resistance to change the previous clinical School of Nursing and Midwifery at Shahid
handoff process. The probability of bias due Sadoughi University of Yazd, Iran. The
to nurses’ awareness about the recording of study was registered as 5641 and was
their voice during clinical handoff is among funded by the Research Department of the
the limitations of this study. university. Therefore, we are grateful to the
Another limitation of the present study is Vice-President of the Research Department
that the study was conducted in a single and all the participants who devoted their
hospital; and therefore, the results may not time to this research.
be generalizable to other medical centers. In
addition, the study design is also considered References
as another limitation. Due to the proximity 1. Anderson J, Malone L, Shanahan K,
of CCU wards in the target hospital and the Manning J. Nursing bedside clinical
possibility of interactions between the handover–an integrated review of issues and
nurses, it was not possible to have a separate tools. Journal of Clinical Nursing.
control group and a parallel design. 2015;24(5-6):662-71.
Therefore, the researchers chose to 2. Riesenberg LA, Leitzsch J, Little BW.
implement pre- and post-intervention design Systematic review of handoff mnemonics
for this study. literature. American Journal of Medical
The results of this study showed that Quality. 2009;24(3):196-204.
instruction on how to use the standard tools 3. Wakefield DS, Ragan R, Brandt J,
and its application in clinical handoffs in Tregnago M. Making the transition to
CCUs has significantly increased the nursing bedside shift reports. The Joint
frequency of provided information in five Commission Journal on Quality and Patient
target domains (18 out of 21 items) of the Safety. 2012;38(6):243-AP1.
standard checklist. 4. Chaboyer W, McMurray A, Johnson J,
Using the ISBAR standard checklist is a Hardy L, Wallis M, Chu FYS. Bedside
practical way to improve nurses’ clinical handover: quality improvement strategy to
performance. Nursing managers can use this “transform care at the bedside”. Journal of
approach to reinforce their staff to make nursing care quality. 2009;24(2):136-42.
positive changes in the nursing system. 5. Etezadi T, Malekzadeh J, Mazlom SR,
Raising awareness of nursing students about Tasseeri A. Nursing handover written
this checklist will also prepare them to apply guideline implementation: A way to
a practical approach in the form of an improve safe performance of nurses in
integrated and organized system. However, intensive care units. Evidence Based Care.
it seems that further studies are needed to 2012;2(2):7-18.
develop structured clinical handoff processes 6. World Health
such as the ones examined in this study, in Organization.Communication during patient
order to investigate its various aspects and to hand-overs. Patient Safety Solutions.
clarify the related barriers, incentives, and 2007;1(3):1-4.
practical solutions. 7. Herawati VD, Nurmalia D, Hartiti T,
Dwiantoro L. the effectiveness of coaching
Conflict of Interest using SBAR (situation,
background,assessment, recommendation)
The authors declare that there are no communication tool on nursing shift
conflicts of interest in the publication of this handovers. Belitung Nursing Journal.
study. 2018;4(2):177-85.

272 Nursing Practice Today. 2020;7(4):266-274

 B. Pakcheshm et al.

8. Raeisi A, Rarani MA, Soltani F. al. Using the ISBAR handover tool in junior
Challenges of patient handover process in medical officer handover: a study in an
healthcare services: A systematic review. Australian tertiary hospital. Postgraduate
Journal of Education and Health medical journal. 2011;87(1027):340-4.
Promotion.2019;8:173. 19. Sarmila K, Raj M, Santosh A. Critical
9. Australian Commission on Safety and Care Nurses' Views on Handover in
Quality in Health Care. External Evaluation Chitwan, Nepal. Connect: The World of
of the National Clinical Handover Initiative Critical Care Nursing. 2019;13:36-45.
Pilot Program Final Report ACSHQC. 20. Schmidt T, Kocher D, Mahendran P,
2011sydney. Denecke K. Dynamic Pocket Card for
10. Matic J, Davidson PM, Salamonson Y. Implementing ISBAR in Shift Handover
bringing patient safety to the forefront Communication. Studies in health
through structured computerisation during technology and informatics. 2019;267:224-
clinical handover. Journal of clinical 9.
nursing. 2011;20(1‐2):184-9. 21. Superville JG. Standardizing Nurse-to-
11. Li P, Stelfox HT, Ghali WA. A Nurse Patient Handoffs in a Correctional
prospective observational study of physician Healthcare Setting: A Quality Improvement
handoff for intensive-care-unit-to-ward Project to Improve End-of-Shift Nurse-to-
patient transfers. The American journal of Nurse Communication Using the SBAR I-5
medicine. 2011;124(9):860-7. Handoff Bundle: The University of North
12. Vretare LL, Anderzén-Carlsson A. The Carolina at Chapel Hill; 2017.
critical care nurse’s perception of handover: 22. Coleman RL. Improving Nurse-to-nurse
A phenomenographic study. Intensive and Handover Through Implementation of
Critical Care Nursing. 2020;7:102807. Standardized SBAR: Gardner-Webb
13. Müller M, Jürgens J, Redaèlli M, University; 2018.
Klingberg K, Hautz WE, Stock S. Impact of 23. Pang WI. Promoting integrity of shift
the communication and patient hand-off tool report by applying ISBAR principles among
SBAR on patient safety: a systematic nursing students in clinical placement.
review. BMJ open. 2018;8(8):e022202. InSHS Web of Conferences 2017; 37:01019.
14. Shahid S, Thomas S. Situation, EDP Sciences.
Background, Assessment, Recommendation 24. Achrekar MS, Murthy V, Kanan S,
(SBAR) communication tool for handoff in SHetty R, Nair M, Khattry N. Introduction
health care–a narrative review. Safety in of situation, background, assessment,
Health. 2018;4(1):7. recommendation into nursing practice: A
15. Uhm J-Y, Ko YJ, Kim S. prospective study. Asia-Pacific journal of
Implementation of an SBAR communication oncology nursing. 2016;3(1):45-50.
program based on experiential learning 25. Sundus.baqer.dawood, Ali RM,
theory in a pediatric nursing practicum: A Bahaaldeen EF. Self-Evaluation of Nurses
quasi-experimental study. Nurse Education and Midwives Practices Using SBAR
Today. 2019. (Situation, Background, Assessment,
16. Barry M. Hand-off communication: Recommendation) Communication Tool on
Assuring the transfer of accurate patient Maternal Health Documentation. Iraqi
information. American Nurse Today. National Journal of Nursing Specialties
2014;9(1):30-1. 2018;31(2):57-67.
17. Joint Commission Center for
Transforming Healthcare releases targeted 26. Yegane SAF, Shahrami A, Hatamabadi
solutions tool for hand-off communications. HR, Hosseini-Zijoud S-M. Clinical
Joint Commission Perspectives. 2012;32(8): information transfer between EMS staff and
1, 3. Emergency Medicine Assistants during
18. Thompson JE, Collett LW, Langbart handover of trauma patients. Prehospital and
MJ, Purcell NJ, Boyd SM, Yuminaga Y, et disaster medicine. 2017;32(5):541-7.

Nursing Practice Today. 2020;7(4):266-274 273

Using “ISBAR” checklist on nursing handoff

27. Spooner, A. J., Aitken, L. M., Corley, 29. Berman A, Snyder SJ, Frandsen G.
A., Fraser, J. F., & Chaboyer.Nursing team Kozier & Erbs Fundamentals of Nursing
leader handover in the intensive care unit concept,process and practice,global edition,
contains diverse and inconsistent content: tenth edition. edition T, editor: Julie Levin
An observational study. International journal Alexander; 2018.
of nursing studies, 2016, 61: 165-172. 30. Shali M, Joolaee S, Hooshmand A,
28. Baghaei R, Khalkhali H, PourRashid S. Haghani H. Committed Nurse: This Patient
the effect of using sbar model in nursing is wrong. Medical Ethics Journal.
handoff on communication dimension of 2016;10(34):11-30.
nursing care from the patientsview. The J 31. Beigmoradi S, Pourshirvani A,
Urmia Nurs Midwifery Fac. Pazokian M, Nasiri M. Review nurses' skills
2016;14(6):562-70. in handover using SBAR tool in general
ward. Evidence Based Care. 2019;9(3):63-8.

274 Nursing Practice Today. 2020;7(4):266-274