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Identify Patients Correctly

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Maria Castellanos

on 24 February 2015

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Transcript of Identify Patients Correctly

What would you do if you were admitted with a minor head injury and needed to stay for 24 hours for observation, and when you wake up, a nursing staff informs you that you are scheduled for a surgery to have a cancerous lump removed, only you realize you were never diagnosed with cancer and had the wrong identification bracelet ?
Group members:
Tristan Bone
Christian Ambray
Maria Castellanos

Josephine Ambray
Carrie Allen
Maria Briseno

Identify Patients Correctly
St. Jude Medical Center
Patients Wristband:
First & Last Name, DOB, and unique ID number (FV - Fullerton Visit Number)
Worn at all times during hospital visit

Patient Identification Requirements:
All the St. Jude staff must implement
Done before any administration of medication or diagnostic procedure
Performed before blood transfusion, with validation from another authorized staff member

Guarantees overall patient safety
Avoids putting the patient at a
unnecessary health risk

West Anaheim
St. Joseph
UCI Medical Center
All patients will have an ID armband on as soon as medically possible & referenced against photo ID. Armbands contain
name, DOB, sex
medical record (Aztec) & acct billing # (barcode)
No identity --"Doe,X"
2 patient identifiers (name & DOB) by all staff
to med administration,
specimen collections
ALL procedures by all staff
Daily name & DOB confirmed against armband/EMR
Blood requires 2nd RN & use of MR# with specific blood info checked
Jehovah Witnesses: yellow armband indicating "no blood"
Psych patients consent to photo which can then used as an identifier
All staff including but not limited to RN,PA, MD, & students in each field must follow
Fountain Valley
Patient Identification
All medical staff uses at least two patient identifiers when administering medications, blood components collecting blood and other specimens and when providing treatments or procedures.
FV uses the
patient’s name
and the
patient’s DOB
(both of which are located on the patient identification band). For infants they use a 3rd identifier the
patient’s medical record #
. Although there is no required certification for it, every morning they do a “Patient safety huddle” where they discuss the importance of accurate patient identification. Some of the complications due to wrong patient identification are wrong bld. transfusion, medication, treatment, etc.
Blood Transfusion
Before initiating blood/blood components for transfusion, the patient is matched to the blood/blood components and the doctor’s order. Also, three identifiers are used at bedside:
patient’s name, DOB and medical record #
In FV they use a two-person verification process. One of the two-person verification team must be qualified to perform the transfusion (e.g. an RN)
The second person on the verification team must be qualified to participate in the process (e.g. an RN, LVN or MD). Also at FV one of the people verifying must be RN on the staff.
On an annual basis, all clinical staff must complete a blood module and transfusion reactions competencies. Failure to comply with this policy will be subject to appropriate performance management pursuant to all applicable policies and procedures.
Los Alamitos
Significance of Findings
The Power of Two Identifiers
Greatly reduce risk of injuring the patient
Avoidance of irreversible damage and death
Hospital stays are unnecessarily extended
Lawsuits due to malpractice are limited
Costs are reduced and patient satisfaction improved

All six of our hospitals are upholding the National Patient Safety Goals by using at least two of the Joint Commission approved identifiers.

The National Patient Safety Goal provides the
minimum requirement that must be upheld be
every hospital.

To Improve Patient Safety
Positive patient identification:
- Hospital armband with name, DOB, and MR number
- Patient's verbal verification of name and spelling

Two patient identifiers (name and DOB )are used when:
taking blood samples,
administering medication or blood
prior to any invasive tests or procedures

What happens if no DOB?
What not to use as identifier?

General Sources of Pt. Identifiers:
-Patient -Guardian
-Relative (parent, spouse, adult child) -Transferring facility

Any patient who is typed and crossmatched to receive blood must retain MR number throughout admission.

The Joint Commision
At Los Alamitos Medical Center the two identifiers used are patents name and date of birth; upon admission a non transferable bracelet is placed on the patients wrist to facilitate the process.

All persons associated with patient care are expected to validate the two patient identifiers prior to any service, treatment or care, including administration of medications, blood or blood components.

Labeling of containers used when collecting blood or specimens should be done the presence of the patient. This requires no special training or certificate and is done to reliably identify treatment or service and eliminate wrong patient errors from occurring.

Insuring that the correct patient gets the correct blood or blood product during transfusion by using two persons verification.

1. Obtain informed consent

2. Check or establish IV access using normal saline and Y tube blood administration set with a 170mm filter, and 18 or 19 gauge needle

3. Complete transfusion reaction form and obtain Blood or blood product

4. Two licensed staff members must verify accurate blood number; group, RH factor, expiration date and compare name and ID number on the patient’s wristband with label on blood and request forms.

5. Record VS before starting infusion at 5ml/min or 300ml/hr. for the first 15min, stay with patient during this time if S/S of adverse reaction STOP infusion, keep vein open with normal saline and new IV tubing, contact MD and Lab. If no adverse reactions record VS after the initial 15 min and again 1 hr. after beginning of infusion.

6. Change administration sets and add-on filters used after administration of each unit or end of 4 hrs. whichever comes first.

to reliably identify the individual as the person for whom the service or treatment is intended.

Acceptable patient identifiers include:
individual’s first and last name
assigned identification number (MM and/or AA number)
date of birth
social security number
patient address
telephone number
other person-specific identifier

Use at least two identifiers prior to
administering medications or blood products
taking blood samples and other specimens for clinical testing or providing any other treatments or procedures.

* The MM# (Medical Record Number) must be used when labeling specimens drawn for the blood bank.

2 patient identifiers: full name and DOB
General Sources: patient, relatives (parents, spouse, adult child) or guardian
All clinical staff must follow procedures
"Oops, Sorry, Wrong Patient!"
Safe Practice Recommendation:

The patient’s MAR should always be brought to the bedside so that a staff member can verify two unique patient identifiers (e.g., the patient’s name and ID number).

Two identifiers (e.g., name, birth-date, and ID number) should be required for all critical processes, especially medication use, diagnosis, and monitoring.
“Patient Identification: Simple Measures, Big Benefits”
The use of two identifiers is one of the least expensive and most common methods.

Failure to implement proper safety initiatives run the risk of losing accreditation from accrediting organizations like the Joint Commission

Strategies to improve patient identification
-bar-coding systems
-reducing the hours staff allowed to work (fatigue)
Psych patients at UCI use identifiers: armband & picture (after consent obtained)
At FV 3 identifiers (name, DOB and MR#) are used for infants and blood transfusions.
Also at FV once a year their staff must complete a blood module and transfusion reactions competencies.

"Clinical Transfusion Process and Patient Safety"
• Blood transfusion can be a life saving intervention if appropriate to clinical needs and correctly administered.

• Safety of blood transfusion depends on blood product and the clinical transfusion process.

• The biggest cause of serious transfusion reaction is wrong blood transfusion due to incorrect identification.

• Training of staff and implementation of standardized procedures can prevent errors and improve patient safety.

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