Misidentifications prevented in a closed-loop environment by a wristband-based information system

Abstract

Background: Error prevention in healthcare is paramount. Beyond introducing computerised provider order entry (CPOE) and automated medication dispensing systems, patient identification systems have also been proposed in an effort to increase patient safety while reducing misidentification. Electronic patient records are thus integrated into closed-loop systems. In Switzerland, there are no systematic data available on misidentification rates in hospitals. This study sought to evaluate the nature and frequency of the misidentifications prevented using a computerised, multipurpose, workflow-integrated patient identification system as part of a fully electronic patient record. We analysed actions comprising phlebotomy, drug administration, and transfusion. Methods: Over a 30-month period, 24 879 in-patient stays in a public hospital were analysed concerning identification system usage and prevented misidentification, focusing on phlebotomy, transfusion, and drug administration areas. All identification checks were performed using the same device and software. Results: The results of 38 199 bedside checks revealed low misidentification rates and moderate system usage within a non-mandatory setting Clear differences were noted between specific tasks. In this setting, a total of 457 misidentifications were prevented by the system. Conclusion: Misidentifications are not common, generally occurring in less than 2% of bedside actions. The absolute numbers are, however, cause for concern and thus merit significant preventive efforts. While implementing a multipurpose system can increase nurse acceptance, this is associated with additional workload pertaining to identification checks, which proves an issue. Increasing patient safety by introducing a wristband identification system, for example, thus appears worthwhile, although it must be designed as to respect the socio-technical environment.