5-Step Standardized Clinical Handover

ISBAR Template & Clinical Handover Tool

The ISBAR framework expands traditional SBAR by adding an explicit initial step for Identification / Introduction (I). Widely adopted across the World Health Organization (WHO), Australia (ACSQHC), and NHS trusts, ISBAR eliminates patient misidentification and ensures clear provider role accountability.

Why the "I" (Identification) Step Is Essential

In complex modern hospitals with rotating residents, cross-covering hospitalists, agency nurses, and multi-disciplinary teams, ambiguous introductions are a frequent root cause of medical handover errors. The Identify step mandates three essential confirmations before clinical details are communicated:

1. Identify Yourself:State your name, professional role (RN, RT, Resident, Attending), and your specific unit or clinical team.

2. Confirm the Receiver:Verify you are speaking to the correct on-call physician, covering provider, or receiving handover nurse.

3. Identify the Patient:State the patient's full name, Medical Record Number (MRN), bed/room location, and gender/age.

ISBAR Clinical Handover Worksheet (Blank)

Standard 5-step handover worksheet optimized for print and clipboard use.

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IIDENTIFICATION — Provider, Patient & Location

• Your Name & Role: _________________________ Unit/Team: _________________________

• Receiving Clinician: _________________________ Role/Service: _________________________

• Patient Name: _________________________ MRN: _______________ Bed: _________

SSITUATION — The Immediate Concern

• Immediate Reason for Call / Handover: __________________________________________________

• Onset / Timing: ____________________ Acuity: [ ] Emergent [ ] Urgent [ ] Routine

BBACKGROUND — Clinical Context & History

• Admission Diagnosis & Date: ___________________________________________________________

• Pertinent Comorbidities & Allergies: ____________________________________________________

• Recent Procedures, Lines & Medications: ________________________________________________

AASSESSMENT — Clinical Findings & Impressions

• Vital Signs: BP: _____/_____ | HR: _____ | RR: _____ | SpO2: _____% on [ ] RA [ ] O2: ____L | Temp: _____

• Key Physical Findings & Deviations from Baseline: ________________________________________

• Clinical Impression: ____________________________________________________________________

RRECOMMENDATION — Explicit Request & Read-Back

• Requested Action / Orders: ________________________________________________________________

• Timeframe Expected: [ ] STAT (within 15 min) [ ] 1 Hour [ ] End of Shift

• Closed-Loop Read-Back Completed: [ ] Yes Confirmed By: _______________________

Fictional Example

ISBAR Clinical Example: Cross-Coverage Deterioration Call

Scenario: Night float registered nurse calling the covering nocturnal hospitalist regarding acute oliguria and fever in a post-operative patient.

I — Identification:"Hello Dr. Chen, this is Nurse Taylor, RN on 4-East Surgical. I am calling to confirm you are covering night hospitalist service for patient George Adams, MRN 48291, in Room 412-Bed B."

S — Situation:"Mr. Adams has developed new-onset oliguria with only 35 mL urine output over the past 4 hours via Foley catheter, accompanied by a new spike in temperature to 101.6°F."

B — Background:"He is Post-Op Day 1 following an open right total hip arthroplasty. History of mild CKD Stage 2 and hypertension. Pre-op creatinine was 1.1 mg/dL. He received 2 doses of IV Ketorolac earlier today. No known drug allergies."

A — Assessment:"Current vitals: BP 96/60 (baseline was 130/80), HR 108 bpm regular, RR 20, Temp 101.6°F, SpO2 96% on room air. The Foley catheter is patent with no kinks or clots. Surgical dressing is dry and intact. I am concerned he is developing acute hypovolemia and early post-op acute kidney injury."

R — Recommendation:"I recommend holding any further NSAID doses, ordering a 500 mL IV Normal Saline fluid bolus over 1 hour, and drawing STAT BMP and CBC. I will repeat vitals and assess urine output in 60 minutes."

Available SBAR Formats

Choose the format that fits your clinical workflow or educational setting.

100% Free & No Sign-up

Editable

Word (.DOCX)Editable table template for MS Word

Cloud

Google DocsOne-click copy to your Google Drive

Interactive

Online SBAR BuilderFill in browser, copy text & print

Authoritative ISBAR Sources & Evidence

•Australian Commission on Safety and Quality in Health Care (ACSQHC): National Standard for Clinical Handover – The ISBAR Implementation Toolkit.
•World Health Organization (WHO): High 5s Project – Standard Operating Protocol for Assuring Medication Accuracy and Structured Handover.
•NHS England: SBAR and ISBAR Structured Handover Communication Guidance in Acute Care.

Educational Handover Framework

This ISBAR template is designed for educational, training, and standardized clinical handover demonstration. Use in clinical practice should adhere to your organization's approved handover policies and medical record systems.