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

Jennifer O'Rourke, Joanna Abraham, Lee Ann Riesenberg, Jeff Matson, Karen Dunn Lopez

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Aim: The aim of this study was to identify the core components of nurse–nurse handoffs. Background: 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. Design: Mixed methods design using the Delphi technique. Methods: 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. Results/findings: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)1659-1671
Number of pages13
JournalJournal of Advanced Nursing
Issue number7
StatePublished - Jul 2018


  • Delphi technique
  • communication
  • handoff
  • handover
  • nurses


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