Bedside Handover Report

*Update this report in pencil and pass it forward to the next nurse during bedside handover.

Identify:

Patient/Family:

Age & Sex:

*Before approaching the bed, pause to highlight any sensitive issues for oncoming nurse

Patient / Family or Emotional / Social / Diagnosis

Situation

Physician/Team:

Code Status:

Isolation:

Admit Date:

Transfer Date:

Diagnosis:

Chief Complaint:

Allergies:

Background

Significant Medical History (refer to the chart for full details):

Assessment

Concerns

Patient/Family Subjective Goal for the Day: ____________________________

Care Criteria (circle one): Ambulatory Assist Total

Vaccines needed prior to discharge

Flu: Yes or No

Pneumonia: Yes or No

Handoff - Isbar - SBAR Report example for the clinical.

Med Surg 1 (NR 463)