Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Promoting Correct Patient Identification in the Intensive Care Unit of a General Hospital in Tabriz, Iran: A Best Practice Implementation Project

Document Type : Original Article

Authors
Amin Talebpour
Mahdi Nouri
Sakineh Hajebrahimi
Fatemeh Rahmati
Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
10.22038/psj.2024.76180.1416
Abstract
Introduction:
Patient identification, defined as the accurate matching of a patient to intended interventions while communicating identity information consistently throughout care, is critical for patient safety. Incorrect patient identification is a leading unintentional cause of patient harm and poses a significant safety challenge in healthcare facilities. This project aimed to enhance correct patient identification in the intensive care unit of a general hospital in Tabriz, Iran. Methods: A clinical audit, utilizing the JBI Practical Application of Clinical Evidence System (JBI PACES) tool, was conducted. Seven audit criteria, representing best-practice recommendations for correct patient identification, were employed. The project involved a baseline audit, the implementation of multiple strategies, and a follow-up audit to assess changes in practice.
 Results:
Significant improvements were observed in the follow-up audit compared to the baseline audit, including the use of at least two identifiers to check patient identity before care (from 22% to 100%), provision of clear protocols for patients lacking identification or with similar identities (from 17% to 94%), labeling of containers in the presence of patients (from 33% to 89%), education of healthcare workers in correct patient identification procedures (from 33% to 94%), patient education on the importance of correct identification procedures (from 28% to 94%), and utilization of white identification bands or biometric technologies across healthcare facilities (from 6% to 22%).
 Conclusions:
The application of standard clinical audit tools in hospitals can enhance the quality of patient services and improve the effectiveness of interventions by identifying weaknesses in the patient care process.
Keywords
Best practice
Correct patient identification
Clinical audit
Evidence-based practice
Person-centered
Subjects
  1. Nouri M, Ghaffarifar S, Sadeghi-Bazargani H. Development of the Persian patient satisfaction questionnaire. Int J Health Care Qual Assur. 2018; 31(8):988-99.
  2. Donaldson MS, Corrigan JM, Kohn LT. To err is human: building a safer health system. 2000.
  3. Corrigan JM. Crossing the quality chasm. Building a better delivery system. 2005;89.
  4. Saadati M, Nouri M, Rezapour R. Patient safety walkrounds; 5 years of experience in a developing country. Int J Health Plann Manage. 2019;34(2):773-9.
  5. Song P, Li W, Zhou Q. An outpatient antibacterial stewardship intervention during the journey to JCI accreditation. BMC Pharmacology and Toxicology. 2014; 15(1): 8.
  6. Bui AL, Lavado RF, Johnson EK, Brooks BP, Freeman MK, Graves CM, et al. National health accounts data from 1996 to 2010: a systematic review. Bull World Health Organ. 2015; 93(8): 566-76d.
  7. Donaldson SLJ, Fletcher MG. The WHO World Alliance for Patient Safety: towards the years of living less dangerously. Medical Journal of Australia. 2006;184(S10):S69-S72.
  8. Askeland RW, McGrane SP, Reifert DR, Kemp JD. Enhancing transfusion safety with an innovative bar-code-based tracking system. Healthc Q. 2009;12 Spec No Patient: 85-9.
  9. Perry DC, Scott SJ. Identifying patients in hospital: are more adverse events waiting to happen? Qual Saf Health Care. 2007; 16(2): 160.
  10. Cardona-Morrell M, Hillman K. Development of a tool for defining and identifying the dying patient in hospital: Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL). BMJ Support Palliat Care. 2015; 5(1): 78-90.
  11. Best WR, Khuri SF, Phelan M, Hur K, Henderson WG, Demakis JG, Daley J. Identifying patient preoperative risk factors and postoperative adverse events in administrative databases: results from the Department of Veterans Affairs National Surgical Quality Improvement Program. J Am Coll Surg. 2002; 194(3):257-66.
  12. Toso GL, Golle L, Magnago TS, Herr GE, Loro MM, Aozane F, Kolankiewicz AC. Patient safety culture in hospitals within the nursing perspective. Rev Gaucha Enferm. 2016; 37(4): e58662.
  13. Hering BJ, Cooper DKC, Cozzi E, Schuurman H-J, Korbutt GS, Denner J, et al. Executive summary. Xenotransplantation. 2009; 16(4):196-202.
  14. Ranade-Kharkar P, Pollock SE, Mann DK, Thornton SN. Improving Clinical Data Integrity by using Data Adjudication Techniques for Data Received through a Health Information Exchange (HIE). AMIA Annu Symp Proc. 2014;2014:
    1894-901.
  15. Duggal R, Khatri SK, Shukla B. Improving patient matching: Single patient view for Clinical Decision Support using Big Data analytics. 2015 4th International Conference on Reliability, Infocom Technologies and Optimization (ICRITO) (Trends and Future Directions). 2015: 1-6.
  16. Rudin RS, Hillestad R, Ridgely MS, Qureshi N, Davis JS, II, Fischer SH. Defining and Evaluating Patient-Empowered Approaches to Improving Record Matching. Santa Monica, CA: RAND Corporation; 2018.
  17. Rebello E, Kee S, Kowalski A, Harun N, Guindani M, Goravanchi F. Reduction of incorrect record accessing and charting patient electronic medical records in the perioperative environment. Health Informatics J. 2016; 22(4): 1055-62.
  18. MacIvor D, Triulzi DJ, Yazer MH. Enhanced detection of blood bank sample collection errors with a centralized patient database. Transfusion. 2009;49(1):40-3.
  19. Thornton SN, Hood SK. Reducing duplicate patient creation using a probabilistic matching algorithm in an open-access community data sharing environment. AMIA Annu Symp Proc. 2005;2005:1135.
  20. Durand AM. Quality improvement and the hierarchy of needs in low resource settings: perspective of a district health officer. International Journal for Quality in Health Care. 2010;22(1):70-2.
  21. Rensburg MA, Nutt L, Zemlin AE, Erasmus RT. An audit on the reporting of critical results in a tertiary institute. Ann Clin Biochem. 2009;46(Pt 2):162-4.
  22. Talebpour A, Hajebrahimi S, Tavani FM, Rahmani P, Ghabousian A, Kabiri N. Protecting healthcare workers against coronavirus disease 2019 in emergency departments at a teaching hospital in Tabriz, Iran: a best practice implementation project. JBI Evid Implement. 2022;20(3):209-17.
  23. Moola S. Evidence Summary: Correct Patient Identification: Acute Care Settings. The Joanna Briggs Institute. 2012.
  24. Kabiri N, Hajebrahimi S, Alizadeh G, Azimzadeh S, Farajzadeh N, Talebpour A. Promoting informed consent in a children's hospital in Tabriz, Iran: a best practice implementation project. JBI Database System Rev Implement Rep. 2019; 17(12): 2570-7.
  25. De Rezende HA, Melleiro MM, Shimoda GT. Interventions to reduce patient identification errors in the hospital setting: a systematic review protocol. JBI Database System Rev Implement Rep. 2019;17(1):37-42.
  26. Marquard JL, Henneman PL, He Z, Jo J, Fisher DL, Henneman EA. Nurses' behaviors and visual scanning patterns may reduce patient identification errors. J Exp Psychol Appl. 2011; 17(3):247-56.
  27. Simsekler MCE, Ward JR, Clarkson PJ. Design for patient safety: a systems-based risk identification framework. Ergonomics. 2018; 61(8):1046-64.
  28. Schulmeister L. Patient misidentification in oncology care. Clin J Oncol Nurs. 2008;12(3):
    495-8.
  29. Paparella SF. Accurate patient identification in the emergency department: meeting the safety challenges. J Emerg Nurs. 2012;38(4):364-7.
  30. Lombardi NF, Mendes AE, Lucchetta RC, Reis WC, Fávero ML, Correr CJ. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Rev Lat Am Enfermagem. 2016; 24: e2760.
  31. Rothman M, Levy M, Dellinger RP, Jones SL, Fogerty RL, Voelker KG, et al. Sepsis as 2 problems: Identifying sepsis at admission and predicting onset in the hospital using an electronic medical record-based acuity score. J Crit Care. 2017;38:237-44.
  32. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. Clinical Biochemistry. 2017;50(10):568-73.
  33. Wu AW, Busch IM. Patient safety: a new basic science for professional education. GMS J Med Educ. 2019; 36(2): Doc21.
  34. Cohen MM, Kimmel NL, Benage MK, Hoang C, Burroughs TE, Roth CA. Implementing a hospitalwide patient safety program for cultural change. Jt Comm J Qual Saf. 2004; 30(8):424-31.
  35. World Health Organization. Patient safety research: a guide for developing training programmes. 2012.
  36. World Health Organization. WHO launches' Nine patient safety solutions'. 2007.
  37. Livingston EH. Solutions for improving patient safe Jama. 2010; 303(2): 159-61.
Journal of Patient Safety & Quality Improvement
Volume 11, Issue 4
Autumn 2023
Pages 223-231