Cardiac stenting is commonly used in the clinical treatment of coronary atherosclerotic heart disease (coronary heart disease) and other cardiovascular diseases. By dilating the diseased coronary artery, it restores myocardial perfusion, thereby improving cardiac blood supply and maintaining normal cardiac function (1). However, due to surgical risks and numerous postoperative precautions, the lack of standardized nursing care can not only increase patient pain due to complications but also negatively affect postoperative recovery and prognosis (2).

The nurse shift system is a core component of hospital management, ensuring continuity of clinical nursing care and reducing the incidence of medical and nursing disputes (3). At present, traditional nurse shift handovers are usually conducted either orally in groups or at the bedside, with night shifts often relying on group oral reports (4). This approach is often mechanical and repetitive, consisting mainly of reading shift reports without logical organization, and bedside handovers sometimes become a mere formality (5). Therefore, intervening effectively in the shift handover process is essential to improving the overall quality of nursing communication and patient care.

Mind mapping is a cognitive organizational tool developed in the early 1970s by Tony Buzan, a renowned British psychologist and educator. It uses words and images to integrate visual and logical thinking, representing ideas through thematic keywords and imagery. By creating a dendritic structure, mind maps connect themes across multiple levels, thereby improving creativity and memory (6). In recent years, mind mapping has received increasing attention in China and has been widely applied in nursing education and clinical practice (7). According to related studies, the situation–background–assessment–recommendation (SBAR) standardized communication model has been widely adopted in the medical systems across many European and American countries (8). As an effective handover communication tool, SBAR facilitates information exchange among healthcare providers and plays an important role in ensuring quality of care and patient safety (9).

Therefore, the present study aimed to explore the effect of combining mind mapping with the SBAR shift turnover model on reducing nursing defects during bedside handovers following cardiac stenting in the cardiology department.

The nursing shift turnover process is considered a critical step in the transfer and acquisition of information among nurses (11). It is generally believed that nursing errors are often caused by incomplete or inaccurate handovers, such as omitted patient information or discontinuity of care during shift transitions, which can negatively affect follow-up nursing care and patient safety (12). Therefore, ensuring the accuracy and integrity of nursing handovers is essential for maintaining the quality and safety of patient care.

Clinically, although the traditional shift turnover process has evolved through extensive practical experience and includes a comprehensive content framework, the information to be transferred is often voluminous and poorly organized, leading to confusion, incomplete recall, and omissions (13).

As a visual and structured cognitive tool, mind mapping facilitates understanding and memory by organizing complex and unstructured information into clear visual diagrams (14). The characteristics of mind mapping include (1) accurate information delivery; (2) visualized thinking; (3) simplicity and overall clarity; (4) improved organization, optimization, and efficiency; and (5) enhanced communication and collaboration. The main advantage of mind mapping lies in its intuitive visual layout, which enables nurses to grasp key information quickly and identify problems efficiently (15).

The SBAR model was first developed and implemented by the U.S. Navy's nuclear submarine and aviation industries (16). Its purpose was to ensure efficient and standardized transmission of crucial information under high-stakes conditions, thereby reducing accidents and communication-related losses (17). In healthcare, SBAR functions as a standardized communication framework, where S (situation) refers to the patient's current clinical status, B (background) refers to relevant medical history, A (assessment) refers to the evaluation of existing problems, and R (recommendation) refers to proposed actions or risk mitigation measures. SBAR is recognized as an effective, evidence-based, and structured communication approach that ensures completeness, timeliness, accuracy, and clarity of information (18).

The results of this study indicated that, compared with the CG, the OG achieved higher scores in information quality, behavioral norms, and interactive support, while the handover time of nurses was significantly shorter. These findings suggest that combining mind mapping with the SBAR shift turnover model can effectively improve handover quality and reduce handover time during bedside shift handovers following cardiac stenting, which is consistent with previous research (19). This improvement may be attributed to the use of mind mapping as a visual cognitive tool centered around keywords and hierarchical relationships, allowing complex and scattered concepts to be presented in a structured and associative manner. Through visual elements such as lines, diagrams, and colors, mind mapping helps nurses form stronger memory links, facilitating rapid understanding and recall (20). Integrating the SBAR framework into the mind map further enhances the orderliness and logical flow of the handover process, ensuring the accuracy and completeness of information (21). In addition, the long-term use of mind mapping during shift handovers enables nurses to develop an integrated cognitive schema, allowing them to conduct handovers systematically and efficiently, ultimately improving work efficiency and shortening handover duration.

Our study also demonstrated that, compared with the CG, the OG achieved better mastery of patient condition, lower defect rates in shift turnover, fewer nursing adverse and complaint events, and higher patient satisfaction. These results indicate that combining mind mapping with the SBAR model can enhance nurses' understanding of patient condition, reduce communication errors, and improve overall care quality, findings consistent with previous studies (22). This effect may be attributed to the ability of mind mapping to promote associative thinking and critical analysis, enabling nurses to synthesize patient data, identify potential risks, and comprehensively evaluate patient needs, thereby reducing the likelihood of omissions during handover. Moreover, prior research has shown that many nursing adverse events stem from poor communication between healthcare providers, including delayed information exchange, unclear messaging, and communication barriers (23). The structured and standardized nature of the SBAR framework ensures precise, complete, and timely transmission of information, thereby minimizing errors and enhancing patient safety (24).

From a cognitive perspective, mind mapping supports dual coding and associative learning by integrating visual and verbal information, which enhances nurses' memory retention and retrieval during handover. Its clear hierarchical structure helps reduce cognitive load and facilitates rapid identification of priorities in patient care (25). Organizationally, combining mind mapping with the SBAR framework provides a shared mental model among nursing staff, promoting consistent information flow and improved teamwork efficiency (26). The visual and structured nature of this approach helps standardize communication, minimize ambiguity, and strengthen situational awareness across shifts (27). Together, these mechanisms help explain why the combined method improves both the accuracy and fluency of shift turnover.

Despite the promising results, this study has several limitations. First, the quasi-experimental design, with group allocation based on admission time rather than full randomization of patients, may introduce selection bias. Second, the single-center design and the relatively modest sample size limit the generalizability of our findings to other settings and broader populations. Future research utilizing a multicenter, randomized controlled trial with larger sample sizes is recommended to confirm the efficacy and wider applicability of the mind map-combined SBAR shift turnover model. Finally, because nurse-level and patient-level outcomes were analyzed at their respective levels without the use of multilevel modeling, residual clustering (with patients nested within nurses) may persist; future studies with larger samples should consider mixed-effects models to account for such clustering. Taken together, these findings support the feasibility and potential utility of mind map-supported SBAR for bedside handovers, while underscoring the need for confirmatory trials to establish causality.

This study found that incorporating a mind map-supported SBAR structure into bedside shift handovers was associated with improvements in key process and patient-reported outcomes in a cardiology unit, including, shorter handover times, fewer observed handover defects, and higher nursing satisfaction. While the direction and magnitude of effects were consistent and clinically meaningful, the single-center setting, small nurse-level sample, and separate analysis of nurse- and patient-level endpoints limit causal inference. Accordingly, our results should be viewed as preliminary evidence of benefit rather than definitive proof of effectiveness. Future studies—ideally multicenter and randomized or cluster-randomized—are warranted to confirm effectiveness, evaluate sustainability and fidelity in routine practice, and examine downstream safety outcomes (e.g., preventable adverse events and readmissions).