Editing Management of Care (section)

=== Handoff communication ===
Handoff is the transfer of both information and responsibility. It should be a structured, interactive, face-to-face or synchronous exchange with an opportunity to ask questions, ideally with limited interruptions, and it should include the opportunity to review relevant data together. Inadequate handoff is a persistent contributor to sentinel events (The Joint Commission, 2017).

'''SBAR''' is the most widely tested structure (Haig et al., 2006):
* '''S'''ituation: who the patient is and what is happening right now.
* '''B'''ackground: the relevant clinical context, diagnosis, and history.
* '''A'''ssessment: what the nurse thinks the problem is.
* '''R'''ecommendation: what the nurse is asking the recipient to do.

A frequent examination point is that the '''R''' is not optional. A nurse who reports abnormal data without stating what is needed has not completed the communication.

'''Read-back.''' Verbal and telephone orders and critical laboratory values must be written down and '''read back''' to the sender for verification. Verbal orders should be reserved for emergencies and situations where the provider cannot access the record, and they must be authenticated by the provider within the time frame set by policy.