BackgroundNurses’ effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context.MethodsA descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis.ResultsThe majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators.Conclusion and recommendationsNursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study’s findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses’ well-being to control or mitigate the effect of psychological precursors on the quality of nurses’ handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.