Verify Patient Identity Research Articles

Factors affecting radiographers' use of dose-reduction measures.

This study investigates radiographers' views on implementing dose-reduction measures, with a focus on verifying patient identity and pregnancy status, practising gonad shielding in men and using compression. An electronic questionnaire was distributed to radiographers working in general radiography and/or computed tomography. The questionnaire was based on factors from a framework for analysing risk and safety in clinical medicine. Ordered logistic regressions were used to analyse associations among factors and use of dose-reduction measures. In total, 466 questionnaires were distributed and 170 radiographers (36%) completed them. Clear instructions and routines, support from colleagues, knowledge and experience, a strong safety culture, managerial support and access to proper equipment influence the likelihood of using dose-reduction measures. The strongest associations were found between support from colleagues and verifying pregnancy status (OR = 5.65,P= 0.026), safety culture and use of gonad shielding (OR = 2.36,P= 0.042), and having enough time and use of compression (OR = 2.11,P= 0.003). A strong safety culture and a supportive work environment appears to be essential for the use of dose-reduction measures, and education, training and stress management can improve utilisation of dose-reduction measures.

Patient Identification Errors in the Hospital Setting: A Prospective Observational Study

Background and aim: In every aspect of clinical care, including diagnostic testing and medication administration, patient identification (ID) errors can disrupt care and harm patients. The study assesses healthcare workers' frequency and accuracy in verifying patient identity before performing common tasks and develops a proposed patient verifying identity program clinical model to meet the training needs of healthcare workers. Methods: An observational cross-sectional study was conducted at Al-Najaf Teaching Hospital from March to May 2022. Data collection was done through a questionnaire and participatory observation. Hundred-forty healthcare workers participated in the study: 52 clinic doctors, 27 registered nurses, 34 information officers, 17 pharmacists, 4 radiologists, and 6 outpatient hospital doctors. Results: The majority of participants (62.1%) were female. The majority of the 40 participants (28.6%) worked in the operating room. Furthermore, the majority of the participants (82.1%) did not ask the patients for their names and dates of birth (DOB). Clinic doctors made up the majority of those who did not complete the identification process (37.1%). Conclusion: More than three-quarters of healthcare workers missed patient identification while performing a task. Although patient identification errors frequently result in serious adverse events that can be avoided with better training, better use of technology may improve the way healthcare workers verify patients' identities.

Clinical Issues-October 2022.

Verifying patient identity before blood product administration Key words: patient identification, patient verification, blood transfusion, blood management, wristband. Surgical site infection risk with allogeneic blood administration Key words: patient blood management, restrictive transfusion triggers, allogeneic blood products, intraoperative blood salvage, surgical site infection. Information on topical thrombin Key words: hemostatic agents, licensed biological product, hemostasis, bovine thrombin, human thrombin. Safe use of topical thrombin Key words: severe adverse events, hemostatic agents, accidental injection, accidental intravascular uptake, product labeling.

Initiative to Increase the Rate of Emergency Department Physician Preprocedure Time-out Documentation

Introduction:The preprocedure time-out is an important safety measure to verify patient identity and accuracy of a planned procedure. The time-out is an institutional and Joint Commission requirement. However, physicians in our emergency departments (EDs) document it inconsistently. We aimed to improve physician preprocedure time-out documentation for deep sedation (ketamine and/or propofol) from 75% to 90%, and separately for cutaneous abscess incision and drainage (I&D) from 94% to 98% by June 2020.Methods:We analyzed 1 year of baseline data and weekly electronic medical record (EMR) reports from November 2019 through June 2020. Our outcome measures were the rate of physician time-out documentation for deep sedation and I&D, respectively; our process measure was physician engagement. Our interventions included education, monthly reminders and updates, individualized feedback for insufficient documentation, EMR deep sedation, and I&D procedure note optimization, and academic and financial incentives. We used statistical process control chart quality improvement rules for discerning special versus common cause variation.Results:Physician documentation of a preprocedure time-out improved from 75% to 100% for deep sedation and from 94% to 99.3% for I&D. These improvements remained sustained. All physicians were eligible for the financial bonus, and 40 (63%) met Maintenance of Certification credit requirements.Conclusions:Using quality improvement methodology, we increased physician time-out documentation for deep sedation and I&D through education, feedback, and systems enhancement. We improved Joint Commission regulatory compliance and reduced potential harm through these safety checks. Future studies may quantify patient safety effects and examine the efficacy of similar interventions for other procedures.

How to verify patient identity and blood product compatibility using an electronic bedside transfusion system.

Transfusion of an incorrect blood component is an important avoidable serious hazard of transfusion resulting from process errors. Our group and others have taken advantage of new technology and developed electronic transfusion systems for safe transfusion practice in a previous studies. They allow the clinical staff to correctly identify the patient and the blood product at the bedside, ensuring the right blood product is given to the right patient. This video is to demonstrate the process and not to promote any specific product. It is a follow up our previous video clip on electronic remote blood issue in a previous study. The process for correct patient identification originates from the wristband, which contains the patient identification details in a 2D barcode and is printed from the electronic patient record system. These details are associated with the blood sample through using a portable printer to produce a label for the sample tube. The patient details are scanned into the blood bank laboratory information system (LIS) and are then printed on a compatibility label by the LIS, which also contains a 2-dimensional barcode, and is then attached to the blood product. Following an initial visual check of these details by the clinical staff, the electronic bedside system requires that both the patient wristband barcode and the blood product compatibility barcode are scanned. This will electronically verify at the patient's bedside that the right unit is to be given to the right patient. This is the final step in ensuring end-to-end electronic control and safe transfusion practice.

National Survey of Hospital Medication Safety Practice during Mass Gathering (Hajj-2016) in Makkah, Saudi Arabia: Patient Information

<p style="text-align: justify;"><strong>Objective:</strong> To explore the national hospital medication safety survey during mass gathering (Hajj -2016) in Makkah, Saudi Arabia: Patient information, the finding of ISMP (2011) self-assessment of medication safety at the hospitals. <strong>Methods:</strong> It is 15 days cross-sectional national survey of hospital medication safety at Makkah region. The survey modified from Institution of Safe Medication Practice (ISMP) self-assessment of hospital medication safety. It consisted of a demographic section and ten domains with 270 questions. The ten areas included patient information, drug information, communication of medication orders, drug preparation, medication distribution, medication devices, work environment, staff competency, patient education, quality process with risk management domain. The medications safety officer at Makkah region distributed the questionnaire and made follow up on a daily basis used physical visiting and through the telephone call. <strong>Results:</strong> The total score of all ISMP-self assessment of medication safety was 3.39 +/-0.51 (67.68 %) with CI (3.2-3.6) P&lt; 0.05. The average rating of patient information domain at all hospital was 2.75+/- 0.57 (55 %) with CI (2.52-2.98) P&lt; 0.05. The highest score of patient information section was the core information of the patient transmitted to the pharmacy 3.91 (78.2%). The lowest score of patient information section was computerized physician order entry (CPOE) with drug allergies 1.73 (34.6%), computerized order entry system with drug allergies alerting severity 1.73 (34.6%), and bar-coding used to verify patient identity during drug administration 1.9 (38%). <strong>Conclusion:</strong> Despite the patient information is very crucial for medication safety; the critical base information missed with the emphasis on patient allergies related issues and verification of medication administration by using new technology. An electronic prescription with complete medication history and alerting system highly recommended to during mass gathering Hajj is essential. Targeting to correct all related patient information measure will prevent drug misadventures, improved patient clinical outcomes, and quality of life. <p style="text-align: justify;"><strong>Key words:</strong> Medication Safety, Hajj, Patient, Information, Ministry of Health, Saudi Arabia.

Analyzing Visual Search Techniques using Eye Tracking for a Computerized Provider Order Entry (CPOE) Task

A challenge with current Computerized Provider Order Entry (CPOE) systems includes patient identification errors, i.e. when an incorrect patient’s record is referenced. These types of errors can lead to patient safety issues such as administrating medication to the incorrect patient. Eye tracking technology can provide insights into the visual search patterns of healthcare professionals and shed light on how patient identification errors occur. This study investigates whether there are differences in visual search metrics, response time, and accuracy when searching for a patient by two identifiers – name or date of birth – from a list of patients with similar names. The findings revealed there was no effect of search strategy on speed or accuracy; however, there was an effect on fixation duration and number of fixations within specific areas of interest. Across both search strategies, there were more fixations on names. This demonstrates the importance of a patient’s name regardless of search strategy and is an important consideration to take into account if multiple patients share the same name. This study shows that eye tracking technology can be used to investigate the visual search patterns employed during patient identification and provide insights as to how patient identification errors occur. It also demonstrates a need to develop alternative methods to prevent patient identification errors apart from relying on healthcare professionals to verify patient identity.

Incidence of Patient Identification Errors observed before Medication and Procedure/Intervention

ABSTRACT Objectives To identify the number of individuals for whom double identification check was done before administering medication and before procedure/intervention, as per Continual Quality Improvement 3j indicator of National Accreditation Board of Hospitals (4th edition) and hospital policy. Materials and methods The study was a concurrent, observational recording of the study population which included doctors/surgeons, nurses, and/or technicians before administration of any medication and before beginning of any procedure/intervention. The observations were recorded on a prepared checklist to find the compliance of incidence of patients’ double identification. Results A total of 34 observations were recorded before administering medication to a patient. In 18 cases, wristbands were not being used, and identification details were incorrect in 4 cases. Of 34 cases, identifiers were illegible in 6 cases. The major area where the error was high was noncompliance to verbal confirmation of identity (ID) and checking it from the patient’s file. Out of 34 observations before a procedure/intervention, 9 errors were identified in cases where the ID band was not used for verification, and identification details on the band were illegible in 5 cases. In six cases, the patient’s name was not verbally confirmed with the patient or carer. Furthermore, in 10 cases, verbally confirmed name was not checked with the patient’s file. Out of 34 cases, double identification was not done in 13 cases. Conclusion Many nurses, doctors, and technicians in clinical settings do not verify patient ID before performing a task, resulting in more than one-third of staff not conforming themselves with the double identification procedure. The study also showed that over three-fourths of the total invasive procedures are compliant to double identification. On the contrary, noninvasive procedures showed less than one-fourth compliance to double identification. How to cite this article Chawla R, Kaushik S. Incidence of Patient Identification Errors observed before Medication and Procedure/Intervention. Int J Res Foundation Hosp Healthc Adm 2016;4(2):100-106.

Pre-analytical phase: The automated ProTube device supports quality assurance in the phlebotomy process

BackgroundMost errors in laboratory medicine occur in the pre-analytical phase of the total testing process. Phlebotomy, a crucial step in the pre-analytical phase influencing laboratory results and patient outcome, calls for quality assurance procedures and automation in order to prevent errors and ensure patient safety. MethodsWe compared the performance of a new small, automated device, the ProTube Inpeco, designed for use in phlebotomy with a complete traceability of the process, with a centralized automated system, BC ROBO. ResultsProTube was used for 15,010 patients undergoing phlebotomy with 48,776 tubes being labeled. The mean time and standard deviation (SD) for blood sampling was 3:03 (min:sec; SD±1:24) when using ProTube, against 5:40 (min:sec; SD±1:57) when using BC ROBO. The mean number of patients per hour managed at each phlebotomy point was 16±3 with ProTube, and 10±2 with BC ROBO. No tubes were labeled erroneously or incorrectly, even if process failure occurred in 2.8% of cases when ProTube was used. ConclusionsThanks to its cutting edge technology, the ProTube has many advantages over BC ROBO, above all in verifying patient identity, and in allowing a reduction in both identification error and tube mislabeling.

Wristbands as aids to reduce misidentification: an ethnographically guided task analysis

Wristbands are recommended in the UK as a means of verifying patient identity but have been little studied. We aimed to document how wristbands are used in practice. and participants Task analysis of wristband application and use, drawing on qualitative analysis of workplace observation of, and interviews with, clinical and non-clinical staff. Two acute district general hospitals in northern England. Our findings indicate high levels of awareness amongst clinical staff of local and national policies on wristband use, but some ambiguity about the details therein. In contrast, non-clinical staff such as ward clerks and porters were less aware of policy, although their actions also expose patients to risks resulting from misidentification. Of seven subtasks identified by the task analysis of wristband application and use, three appeared to offer particular opportunity for error. Making the decision to apply, especially in emergency patients, is important because delay in application can delay correct identification. Advance preparation of wristbands for elective admission without the patient being present can risk erroneous data or misapplication. Lastly, utilization of wristbands to verify patient identity was greater in some clinical circumstances (blood transfusion and medication administration) than in others (before transferring patients around the hospital and during handovers of care). Wristbands for patient identification are not being used to their full potential. Attention to detail in application and use, especially during handover and transfer, and an appreciation of the role played by 'non-clinical' staff, may offer further gains in patient safety.

Identifying the ‘right patient’: Nurse and consumer perspectives on verifying patient identity during medication administration

Accurate verification of patient identity during medication administration is an important component of medication administration practice. In medical and surgical inpatient settings, the use of identification aids, such as wristbands, is common. In many psychiatric inpatient units in Victoria, Australia, however, standardized identification aids are not used. The present paper outlines the findings of a qualitative research project that employed focus groups to examine mental health nurse and mental health consumer perspectives on the identification of patients during routine medication administration in psychiatric inpatient units. The study identified a range of different methods currently employed to verify patient identity, including technical methods, such as wristband and photographs, and interpersonal methods, such as patient recognition. There were marked similarities in the perspectives of mental health nurses and mental health consumers regarding their opinions and preferences. Technical aids were seen as important, but not as a replacement for the therapeutic nurse-patient encounter.

Patient Identification Errors Are Common in a Simulated Setting

We evaluate the frequency and accuracy of health care workers verifying patient identity before performing common tasks. The study included prospective, simulated patient scenarios with an eye-tracking device that showed where the health care workers looked. Simulations involved nurses administering an intravenous medication, technicians labeling a blood specimen, and clerks applying an identity band. Participants were asked to perform their assigned task on 3 simulated patients, and the third patient had a different date of birth and medical record number than the identity information on the artifact label specific to the health care workers' task. Health care workers were unaware that the focus of the study was patient identity. Sixty-one emergency health care workers participated--28 nurses, 16 technicians, and 17 emergency service associates--in 183 patient scenarios. Sixty-one percent of health care workers (37/61) caught the identity error (61% nurses, 94% technicians, 29% emergency service associates). Thirty-nine percent of health care workers (24/61) performed their assigned task on the wrong patient (39% nurses, 6% technicians, 71% emergency service associates). Eye-tracking data were available for 73% of the patient scenarios (133/183). Seventy-four percent of health care workers (74/100) failed to match the patient to the identity band (87% nurses, 49% technicians). Twenty-seven percent of health care workers (36/133) failed to match the artifact to the patient or the identity band before performing their task (33% nurses, 9% technicians, 33% emergency service associates). Fifteen percent (5/33) of health care workers who completed the steps to verify patient identity on the patient with the identification error still failed to recognize the error. Wide variation exists among health care workers verifying patient identity before performing everyday tasks. Education, process changes, and technology are needed to improve the frequency and accuracy of patient identification.

Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback

Background:The potential severity of wrong patient/procedure/site of surgery and the view that these events are avoidable, make the prevention of such errors a priority. An intervention was set up to...

Providers Do Not Verify Patient Identity during Computer Order Entry

Improving patient identification (ID), by using two identifiers, is a Joint Commission safety goal. Appropriate identifiers include name, date of birth (DOB), or medical record number (MRN). The objectives were to determine the frequency of verifying patient ID during computerized provider order entry (CPOE). This was a prospective study using simulated scenarios with an eye-tracking device. Medical providers were asked to review 10 charts (scenarios), select the patient from a computer alphabetical list, and order tests. Two scenarios had embedded ID errors compared to the computer (incorrect DOB or misspelled last name), and a third had a potential error (second patient on alphabetical list with same last name). Providers were not aware the focus was patient ID. Verifying patient ID was defined as looking at name and either DOB or MRN on the computer. Twenty-five of 25 providers (100%; 95% confidence interval [CI] = 86% to 100%) selected the correct patient when there was a second patient with the same last name. Two of 25 (8%; 95% CI = 1% to 26%) noted the DOB error; the remaining 23 ordered tests on an incorrect patient. One of 25 (4%, 95% CI = 0% to 20%) noted the last name error; 12 ordered tests on an incorrect patient. No participant (0%, 0/107; 95% CI = 0% to 3%) verified patient ID by looking at MRN prior to selecting a patient from the alphabetical list. Twenty-three percent (45/200; 95% CI = 17% to 29%) verified patient ID prior to ordering tests. Medical providers often miss ID errors and infrequently verify patient ID with two identifiers during CPOE.

A new journal devoted to patient safety in surgery: the time is now!

A new journal devoted to patient safety in surgery: the time is now!

Ten Simple Strategies to Prevent Chemotherapy Errors

Safety experts currently recommend using technology to prevent medication errors. Computerized prescriber order entry, automated medication-dispensing machines, and bar coding are a few of the technologies being advocated to promote safety. Simple, easily implemented safety strategies to prevent chemotherapy errors should not be overlooked and include consistent use of a reliable method to verify patient identity, metric measurement, and workplace illumination and organization. Other strategies are elimination of abbreviations and acronyms, provision of up-to-date information at the point of care, and partnering with patients for safety. These strategies can be customized for use in a variety of practice settings. Oncology nurses are at the forefront of chemotherapy error-prevention initiatives and play a key role in implementing safety measures.