Background <p>The Joint Commission established the 2006 National Patient Safety Goals and the 2010 Provision of Care standard requiring an organization to have a standardized process between the patient handoff giver and receiver. Inconsistent communications during patient handoffs increase the patient safety risk. There is limited evidence about the quality of patient handoff communication at shift change between nurses.</p> Methods <p>This is a cross-sectional observational study with a 24-question online survey conducted from June 17 through September 15, 2024, to examine hospital nurses’ experience with the quality of patient handoffs at shift change. Ordinal and multivariable regressions analyzed and controlled for specialty, license type, education level, and years of experience. This analysis includes responses from 688 direct care nurses in U.S. hospitals (i.e., acute care nurses). The primary measure was nurses’ experiences of the quality of patient handoffs at shift change including: (a) missed patient care information, (b) information completeness and accuracy, (c) frequency of patient involvement, and (d) problematic shift changes for patients at an organization.</p> Results <p>1029 nurses responded to the survey, and 688 met the survey analysis inclusion criteria. More than 1 in 4 nurses agreed or strongly agreed that important patient care information is often missed during shift change handoffs and that shift changes are problematic for patients in their hospitals. Only 6.3% of hospital nurses noted that the shift change handoffs they receive from the outgoing nurse are “always” accurate, complete, and pertinent to the patients’ conditions, while only 6.4% reported that they “always” engaged and involved patients during shift change handoffs. When stratified and controlled by specialty, license type, level of education, and years of experience, these results vary.</p> Conclusions <p>Nurses in hospitals experience inconsistent quality of patient handoffs at shift change, with only a minority reporting consistently high-quality and accurate handoffs. These findings highlight the normalization of broken, inaccurate, and unsafe shift change reports from direct care nurses’ perspectives, pointing to the need for further research and diversified interventions to support diverse nursing professionals.</p> Clinical trial registration <p>Clinical trial number: not applicable.</p>