Implementation of a Two-Nurse Bedside Safety Scan During Handover

By Hui Wing Shun Donna, RN, MSc, Ward 21/F


Medical ward patients are often presented with complicated medical history, therefore the accurate transfer of patient information is necessary and important. Currently, clinical handover occurs at the nursing station using the ISBAR format, given by the out-going nurse to the in-coming nurse. Patient files and drug charts are checked by the in-coming nurse and patient rounding occurs after clinical handover, conducted by the in-coming nurse.

Purpose and Problem Statement

Insufficient nurse communication and the complexity of patient needs can lead to discrepancies in handover, which can compromise patient safety and experience. In fact, communication breakdowns in health settings have been found that include miscommunication of essential information, prolonged handover and the lack of referral to documentation. Literature has shown that studies that implemented two-nurse bedside safety scan improved accuracy of handover, improved nurse-patient communication and nurse accountability.

Implementation Plan

The study was conducted over a two-week period. For pre-data collection, an online questionnaire was sent to all nurses in ward 21/F polling their perception of clinical handover. An introductory talk was given to all nurses regarding the implementation of two-nurse bedside safety scan, they were also given a pre-designed safety scan guide card that act as a guide during rounding of patients. In-coming and out-going nurses round patients together after the AM to PM shift clinical handover. The same online questionnaire was given to all nurses again to determine changes after the implementation.


A decrease of 8.8% was found in discrepancies between handover information and actual patient condition. An increase of 11.8% of nursing staff reported they have sufficient information and ample opportunities to ask questions. An increase of 23.6% of nursing staff reported they are able to clarify information. A decrease of 5.9% of nursing staff reported they receive irrelevant information and an increase of 5.8% of nursing staff reported interruption during handover.  

Recommendations and Next Steps

Two-nurse bedside safety scan could be incorporated into routine practice, and to minimise interruptions, safety scan should be carried out especially for complicated cases. Two-nurse bedside safety scan could also be implemented as part of bedside handover in the future.