Assessment of clinical handover among ICU nurses based on the structured ISBAR model (2025).

backgroundClinical handover is recognized as a fundamental and important factor in patient safety. About 80% error rate and 70% of serious adverse events related to incomplete clinical handovers. Effective handovers help to reduce medical errors, prevent inappropriate interventions, and ensure continuity of care. In contrast, incomplete handovers may lead to incorrect clinical judgments, delayed treatment, and increased healthcare costs. This study aimed to assess the current status of clinical handover in intensive care units based on the structured ISBAR tool (Identification, Situation, Background, Assessment, Recommendation).

methodsA descriptive cross-sectional study was conducted in 2025 at six ICUs of Shahid Beheshti Hospital, Kashan, Iran. Using convenience sampling, 124 eligible ICU nurses were included. A total of 370 clinical handovers were directly observed and evaluated. Data were collected via a demographic questionnaire and a structured ICU handover checklist. Descriptive statistics (frequency, percentage, mean, and standard deviation) were analyzed using SPSS version 16.

results370 Clinical handovers from 124 nurses were evaluated. Most of the nurses were female (84.7%) with a bachelor’s degree (90.3%) and were employed under permanent contracts (74.2%). The nurses were aged 28 to 48 years, with 4 to 24 years of work experience. Finding revealed low to moderate compliance (21–58%) with the “Identification” indicator, moderate to good compliance (67–76%) with “Situation” indicator, poor compliance (19.45%) with “Background” indicator, a notable variation from poor to excellent compliance (9.2% to 83.19%) for the “Assessment” indicator and finally excellent compliance (91–96%) with “Recommendation” indicator in clinical handovers among ICU nurses.

conclusionThis study highlights substantial variability in nurses’ compliance with ISBAR components during ICU clinical handovers. Low to moderate adherence was observed for Identification and Background, with inconsistent performance in Assessment. In contrast, Situation and Recommendation indicators showed considerably higher compliance, reflecting their perceived priority for conveying urgency and actionable care plans. These gaps, likely driven by absent standardized protocols, high workload, time constraints, inadequate training, and assumptions of shared knowledge, increase risks of misidentification, communication breakdowns, and compromised patient safety. CLINICAL TRIAL NUMBER: Not applicable.