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Shift Transition Communication Among Nurses: A Systematic Review of ISBAR and SBAR-Based Structured Handover Tools
Aminath Rasiya1,2, Ulfa Abdul Raheem1,3
1Faculty of Health Sciences, Villa College, Malé, Maldives.
Aim:
To evaluate the existing literature on structured handover tools, including the ISBAR and SBAR-based structured handover frameworks, and synthesize recent evidence on their effectiveness in reducing communication errors during nursing shift handovers and patient transfers.
Design:
A systematic review using a synthesis without meta-analysis.
Review Methods:
Fifteen English-language, open-access studies published between 2019 and 2024 were identified through title and abstract screening using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies. Due to methodological heterogeneity, a synthesis without meta-analysis was undertaken. The review focused on nurse-led handovers occurring during within-unit shift changes and inter-unit patient transfers, consistent with the eligibility criteria.
Data Sources:
Studies were retrieved from PubMed, Scopus, the British Nursing Database, the Cumulative Index to Nursing and Allied Health Literature, and MEDLINE on 28 September 2024.
Results:
Structured handover tools including SBAR and ISBAR-based frameworks were generally associated with improved communication, enhanced patient safety and fewer reported adverse events across a range of clinical settings. Structured training supported effective implementation, with most studies reporting improved adherence when training was provided. However, mixed findings were reported, particularly in complex or context-specific settings, indicating variability in effectiveness across study designs and environments.
Conclusions:
Structured handover tools, including ISBAR and SBAR-based frameworks, may support improvements in communication quality and patient safety during nursing shift handovers and patient transfers. While most studies reported positive outcomes, findings were mixed in some settings, highlighting the influence of context, transfer type and training on effectiveness and indicating a moderate level of certainty in the available evidence.
Implication For The Profession And/Or Patient Care:
Structured handovers may strengthen patient safety by supporting clear, complete and consistent communication between nurses during routine clinical transitions.
Impact:
Problem addressed: Communication errors during shift handovers and patient transfers.
Main Findings:
Structured handover tools were commonly associated with improvements in communication and may contribute to patient safety benefits. Research impact: Indicates the potential value of structured communication practices across diverse clinical settings and handover contexts.
Reporting Methods:
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and used a synthesis without meta-analysis.
Patient Or Public Contribution:
There was no direct patient or public involvement.
Ethics Approval/Institutional Registration:
Approved by the Villa College Ethical Centre for Postgraduate Studies (Reference Number: VC/CPS/2024/RA-185).
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