Student Handoff Note (I-PASS)

Handoff Session Header

Date/Time of Handoff: [Date and time]

From: [Name], Student, [Service/Team], [Contact method]

To: [Name], [Role], [Contact method]

Shift Covered: [Shift description and times]

Reviewed with Supervising Resident: [Yes / No] (If yes, include resident name)

Confidentiality: Confidential handoff tool—do not print or share outside approved systems.

Patient Roster Overview

(Include if handing off multiple patients; list in order of acuity: unstable → watcher → stable)

• [Patient name, one-liner, illness severity]
• [Patient name, one-liner, illness severity]
• [Patient name, one-liner, illness severity]

Patient Handoff Block

(Repeat this block for each patient; order by acuity: unstable → watcher → stable)

Patient Identifiers & Safety Snapshot

Patient: [Name], [MRN], [DOB/Age], [Sex]

Location: [Unit], [Room/Bed]

Team/Attending: [Primary team/service], [Attending name]

Illness Severity: [Stable / Watcher / Unstable] (If watcher or unstable, include brief justification)

Code Status: [Code status] [verified / needs confirmation] (If unknown: "Unknown—verify on chart")

Allergies: [Allergen(s) and reaction type(s) / NKDA] (If unknown: "Unknown—verify on chart")

Isolation/Precautions: [Type / None] (If not documented: "Not documented—confirm with team")

Airway/O2: [Room air / NC at L/min / Mask / Ventilator settings]

Lines/Tubes/Drains: [List only those relevant to overnight care] (If none: "None")

Critical Meds: [High-risk therapies with indication: anticoagulation, insulin, antibiotics, pressors] (If none: "None")

Patient Summary

One-liner: [Age/Sex] with [key PMH] admitted for [diagnosis], hospital day [#], currently [status].

• Key hospital course events: (2–5 major events, procedures, or complications)
  • [Event with date/time if relevant]
  • [Event with date/time if relevant]
• Active problems with overnight plan: (List in decreasing severity)
  • [Problem]: [Current status]. Overnight: [Specific instructions, thresholds, do/don't].
  • [Problem]: [Current status]. Overnight: [Specific instructions, thresholds, do/don't].
• Pertinent vitals and labs: [Summarize trends and key abnormalities with dates; only those affecting overnight decisions]
• Pending results: [Study/test]: expected [time] → [anticipated action if abnormal] (Include only those likely to change management overnight or early AM)

Action List

(List all pending tasks; if none, state "No pending overnight tasks")

• [Time/trigger]: [Task] ([Owner]) → [Interpretation and next action]
• [Time/trigger]: [Task] ([Owner]) → [Interpretation and next action]

Situation Awareness & Contingency Plans

(Required for watcher/unstable patients; include for stable patients if relevant concerns exist. Use specific measurable thresholds.)

• If [specific trigger/threshold] → [action], notify [who]
• If [trigger/threshold] → [action], escalate to [senior resident / attending / rapid response]

(If stable with no specific overnight concerns: "No specific overnight concerns anticipated.")

Receiver Synthesis

Read-back completed: [Yes / No]

Receiver restates key points: [Brief restatement of critical items]

Questions/clarifications: [Questions raised and resolutions]

(If verbal handoff not performed, note "Verbal handoff not performed" and indicate follow-up plan)