STRUCTURED NURSING HANDOVER PRACTICES AND THEIR ROLE IN ENHANCING PATIENT SAFETY, COMMUNICATION EFFICIENCY, AND CLINICAL OUTCOMES: A SYSTEMATIC REVIEW

Abstract Background: Nursing handovers are critical for ensuring patient safety, continuity of care, and effective clinical communication. Poorly executed handovers can lead to adverse events due to information loss, communication breakdowns, and reduced situational awareness. This systematic review aimed to explore the relationship between nursing handover quality and patient-related outcomes, with a focus on standardized communication tools, environmental factors, and patient participation. Methods: Following PRISMA guidelines, a comprehensive search was conducted across PubMed, CINAHL, Scopus, and Web of Science for studies published between 2012 and 2022. Studies were included if they examined nursing handovers and reported outcomes related to communication quality, patient safety, or clinical errors. Nine studies met the inclusion criteria and were synthesized using qualitative thematic analysis. Results: Most studies demonstrated that high-quality, structured handovers positively influence patient outcomes by improving communication clarity, reducing errors, and enhancing early recognition of clinical deterioration. Tools such as ISBAR and PACT increased the completeness of information exchange. Environmental distractions, inconsistent documentation, and lack of standardization were common barriers. Experienced nurses demonstrated better retention and interpretation of critical cues. Patient participation showed promise but was limited by concerns about confidentiality and workflow disruptions. Conclusion: Effective nursing handovers are essential to patient safety. Standardized communication tools, leadership support, nurse training, and strategies to minimize interruptions are key to improving handover quality. Future efforts should address both systemic and human factors to support sustainable improvements in handover practices.