Purpose for the Program
To improve the patient-identification process for neonates and to eliminate patient-identification errors, resulting in safe passage for the patient. The lack of a bar code on the infant armband makes it impossible to scan the patient prior to procedures. As a result, staff often will scan the chart, which may lead to patient-identification errors.
To securely and safely place a bar code identification band on each infant so that it can be easily seen, scanned without disturbing the infant, and be consistently used to identify the infant. Considering skin integrity, infant size, access, environment, and ease of application we decided to place an adult band adjusted to fit our bar code on the monitor leads. Leads remain on the infant for the duration of the hospital stay.
Implementation, Outcomes, and Evaluation
A trimmed identification band with the bar code is attached to the lead wires before the leads are placed on the infant. The band will stay between the infant and the cable juncture, which lies outside the infant nesting area. This allows the label to be scanned and the patient identification can be made without disturbing the infant. Prior to implementation, identification errors were erratic and often exceeded those of the hospital as a whole. Since implementing the new identification system in the neonatal intensive care unit, patient-identification errors for neonatal intensive care unit admissions were reduced to zero for a 4-month period. During the following month, one error was discovered as a result of failure to follow the new identification procedure. Retraining and reinforcement continues.
Implications for Nursing Practice
Nurses were given additional educational information regarding the importance of scanning the infant rather than the chart. Nurses and respiratory therapists also were educated regarding the importance of labeling all specimens at the bedside, and respiratory therapists were instructed to refuse specimens, specifically blood gases, that were not properly labeled.