Draft {{ draftLabel }} · Self-check {{ checkProgress }} · Quiz {{ quizLabel }} ✓ Complete
S15 · Self-directed lesson

Clinical Handover Using ISOBAR

Structured handover transfers clinical responsibility safely. Work through this lesson at your own pace, draft a full handover, then check yourself against the model.

⏱ ~30 MINUTES·✍ ANSWERS SAVE AUTOMATICALLY·📄 PRINTABLE WORKSHEET
By the end of this lesson you can…
1

Deliver a complete ISOBAR handover — all six letters, in order.

2

Confirm the patient with two identifiers and confirm the receiver.

3

Transfer every outstanding risk explicitly to the oncoming nurse.

4

Avoid the communicating-for-safety failures that trigger an NYS.

↳

Why it matters: ISOBAR is embedded in every Section D scenario. Get it automatic here and it pays off across the whole OSCE.

🎓
In class you'll do this for real

Your assessor will give you a patient brief and an ISOBAR template, then play the oncoming nurse. You hand over to them out loud. You're marked on completeness of every letter and explicit transfer of every risk. This lesson is your rehearsal.

Part 1 · The framework

ISOBAR, letter by letter

Tap each letter to expand what belongs in it.

IIdentifyYou · the patient · the receiver

State your own name, role and ward. Confirm the patient with two identifiers (e.g. full name + DOB or MRN) against the armband. Confirm the receiver's identity and role, and flag any allergy/alert band.
SSituationThe headline, in a sentence or two

The current clinical situation in one or two sentences — the chief problem and how acute it is right now. Orient the receiver immediately.
OObservationsCurrent vitals · EWS · pain

Current vital signs and track-and-trigger / EWS score, pain, fluid balance and BGL where relevant. Give the trend, not just one number — it drives the receiver's priorities.
BBackgroundHistory · diagnosis · alerts · devices

Admission date, presenting complaint, diagnosis, relevant history, allergies/alerts, lines and devices, pending investigations and recent procedures. Context that prevents repeated work and missed risks.
AAssessment / ActionsYour judgement of the trajectory

Your nursing assessment and clinical judgement — improving or deteriorating? — and the actions you've already taken. The receiver needs your interpretation, not just data.
RResponsibility / RecommendationsRisks · actions · the handoff

State every outstanding risk (falls, pressure injury, deterioration, delirium…), the required actions and timeframe, then explicitly transfer responsibility and invite clarification.
⚠ Critical-safety points — automatic NYS

Two ways to fail before you've finished

No patient identification
Omitting critical information or outstanding risks
Pre-empt these common errors
✗ Missing ISOBAR elements — skipping a letter under pressure
✗ No patient identification
✗ Omitting critical information or outstanding risks

Tip: use the ISOBAR template as a checklist so nothing gets skipped — work down the letters in order, every time.

Part 2 · See one

A complete ISOBAR, spoken

Try to picture the handover first — then reveal it.

I — "I'm Jane Smith, RN, night shift, Ward 4B, handing over to you, Dr Lee, the day RN. This is Mr Robert Tan, DOB 04/09/1951, MRN 482210 — confirmed against his armband. Penicillin allergy, red band on."
S — "Day 2 post right total hip replacement. Stable overnight but reporting increasing pain this morning."
O — "0630 obs: BP 138/84, HR 88, RR 18, SpO₂ 96% on room air, Temp 37.1, EWS 1. Pain 6/10 at rest; last analgesia 0400."
B — "Admitted 20/06 for elective THR. History of T2DM and AF — on apixaban. Penicillin allergy. Bloods pending this morning."
A — "Pain not controlled on the current regimen and mobilising less than expected. Trajectory stable but needs review."
R — "Risks: falls, VTE and pressure injury. Please review analgesia this morning, physio is booked for the afternoon, recheck obs at 1000. I'm transferring responsibility to you — any questions?"
Part 3 · Do one

Build your own handover

Read the brief, then draft each letter. Stuck? Open a hint. Done? Reveal the model and compare.

Patient brief · 0700 night-to-day handover
Mr David Thompson, DOB 14/02/1948, MRN 553120 — Bed 12, Ward 4B.
Admitted 19/06 (day 2) with community-acquired pneumonia; on IV ceftriaxone.
Overnight: febrile 38.6°C at 0300 — paracetamol given, temp now 37.4°C.
0630 obs: BP 132/78, HR 92, RR 22, SpO₂ 92% on 2 L, Temp 37.4, EWS 2 (was 4 at 0300).
New intermittent confusion overnight; oriented now but drowsy.
Penicillin allergy — red band in situ.
Peripheral IV cannula, left forearm, 72 h — due for re-site today.
Awaiting morning bloods and a chest X-ray. Family updated overnight.
Risks on the board: respiratory deterioration · falls (confusion + age) · delirium · IV access due.
First, lock in identification (this is the automatic-fail step)
I
Identify
Open the handover: who you are, who you're handing to, who the patient is.
State your name and role, confirm the patient with two identifiers against the armband, name the penicillin allergy band, and confirm who you're handing over to.
Model: "I'm [your name], RN, night shift, Ward 4B, handing over to you, [receiver], the day RN. This is Mr David Thompson, DOB 14/02/1948, MRN 553120 — confirmed against his armband. Penicillin allergy, red band in situ."
S
Situation
The headline — the main problem and how stable he is right now.
One or two sentences: the main problem (pneumonia, day 2) and the overnight change that matters (fever + new confusion).
Model: "Day 2 of admission with community-acquired pneumonia. Stable overall but he had a febrile episode and new intermittent confusion overnight."
O
Observations
Current vitals, EWS and the trend since the overnight event.
Give the full 0630 set and the trend — EWS down from 4 to 2 — plus the oxygen requirement and last paracetamol.
Model: "0630 obs: BP 132/78, HR 92, RR 22, SpO₂ 92% on 2 L nasal prongs, Temp 37.4, EWS 2 — down from 4 at 0300. Last paracetamol 0300."
B
Background
Admission, treatment, allergy, devices and pending investigations.
Admission date & diagnosis, the antibiotic, the penicillin allergy, the cannula at 72 h, and what's still pending (bloods, CXR).
Model: "Admitted 19/06 with CAP, on IV ceftriaxone. Penicillin allergy. Peripheral cannula in the left forearm at 72 hours, due for re-site. Awaiting morning bloods and a chest X-ray."
A
Assessment / Actions
Your judgement — improving or deteriorating? — and what you did.
Is he getting better or worse? EWS improving but new confusion + overnight fever = watch for delirium / worsening infection. Name what you did (paracetamol, closer monitoring).
Model: "I think he's responding to treatment — EWS is improving — but the new confusion and overnight fever concern me; could be early delirium or worsening infection. I gave paracetamol and increased his monitoring overnight."
R
Responsibility / Recommendations
Every risk, the actions + timeframe, then explicitly hand over.
Name all four risks (respiratory deterioration, falls, delirium, IV access), give the actions + timeframe (re-site cannula, chase bloods/CXR), and explicitly transfer responsibility — then invite questions.
Model: "Risks to watch: respiratory deterioration, falls and delirium from the confusion, and IV access. Please re-site the cannula this morning, chase the bloods and chest X-ray, and reassess if his EWS rises. I'm handing over responsibility to you — any questions?"
Part 4 · Mark yourself

Completeness self-check

This is exactly what your assessor marks. Tick each one your draft covers.

Marking criteria
{{ checkProgress }}
✓Identified yourself — name and role
✓Confirmed the patient with two identifiers
✓Confirmed the receiver's identity & role
✓All six ISOBAR letters covered, in order
✓Current observations + EWS given, with the trend
✓Every outstanding risk stated explicitly
✓Responsibility transferred + invited questions
Part 5 · Knowledge check

Quick quiz

{{ quizLabel }}

Pick an answer to see if you're right and why.

{{ q.q }}
{{ opt.text }} ✓ ✗
Correct. {{ q.explain }}
Not quite. {{ q.explain }}
✓ Lesson complete

You're ready to hand over.

• ISOBAR = Identify · Situation · Observations · Background · Assessment/Actions · Responsibility/Recommendations.
• Two identifiers + confirm the receiver — every single time.
• State every outstanding risk and explicitly transfer responsibility.
• Missed identification or an omitted risk is an automatic NYS.
• ISOBAR is in every Section D scenario — keep rehearsing until it's automatic.

Finish your draft to complete

Fill in the two identifiers, the receiver, and all six ISOBAR letters above. Your progress is saved automatically — you can come back to it.

Nice — your handover is complete

All six letters and your identifiers are in. Compare against the models, tick off the self-check, then mark the lesson complete.