Nurse Manager Handover Checklist Form
Complete this checklist to ensure a thorough and effective shift-to-shift handover for the nursing unit.
Date and Shift
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Unit Census (current number of patients)
*
Staffing Status
*
Please Select
Adequate
Short-staffed
Overstaffed
Critical Incidents or Patient Safety Events
*
Outstanding Tasks or Follow-ups
*
Admissions and Discharges During Shift
*
Equipment and Supply Status
*
Please Select
All functional and stocked
Issues reported
Infection Control Issues
*
Please Select
None
Reported/Under investigation
Handovers/Updates from Other Departments
*
Additional Notes or Concerns
Submit Handover
Should be Empty: