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Patient safety and wristbands

I went to a meeting organised by "Intellect" (the UK's trade association for the IT industry) recently. The National Patient Safety Agency (NPSA) launched an intitiative to increase awareness of the importance of patient wristbands in patient safety. Incorrect patient ID is thought to be one of the main causes of "patient safety incidents".

Chris Ranger, the NPSA's head of safer practice, used the case of Graham Reeves, who had his remaining healthy kidney removed by mistake, to illustrate the potentially tragic consequences of human error in healthcare.

Even those NHS trusts that use patient wristbands do so inconsistently: some blue for men and red for women and some the opposite, for example!

Barcodes have been used for some time in healthcare and are still a reliable stalwart for wristbands, but please see this amusing anecdote posted on the E-Health Insider website (look at the first comment at the end of the article)about how clinical staff can "innovate" with them.

Both Chris Ranger and Alison Terry of the National Audit Office mentioned RFID as a technology with the potential to improve patient safety, either by allowing more confident patient-ID or by helping to prevent wrong patient, wrong site errors.

The NPSA has launched a briefing paper (PDF) on the use of patient wristbands.

The NPSA says, however, that wristbands do not remove clinicians’ responsibility for checking patients’ identity. They are an important way of validating identification particularly when a patient is unable to provide their own details.

Like all aids to identification, barcodes and RFID carry the risk that we "believe" them; cross checking against the patient notes, or--as in the case of a Wi-Fi tag pilot in Birmingham Heartlands Hospital--with a photo on the EPR, is still essential.


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» Right patient, Wrong Site—Right Technology? from Future Health IT
Another tragic wrong site error in the UK remarkably similar to the Graham Reeves case referred to in this FHIT entry on patient safety. That entry also notes that Radio Frequency Identification (RFID) may help to prevent this kind of... [Read More]

» NPSA Patient Wristband Specification from Future Health IT
The National Patient Safety Agency (NPSA) is developing a standard specification for patient wristbands in the NHS in England and Wales. This second phase of work follows from earlier guidance issues in November 2005 and reported in this FHIT entry.... [Read More]


This looks very impressive

While wristbands seem like a good idea, my understanding is that they can be unpopular with patients.

Does 'barcoding' people add to the impression of mechanising healthcare and removing the human touch - and would RFID make things better or seem that bit more sinister to patients?

Yes, I have my own reservations regarding the use of bar codes for this application.

Bar codes are easy to mimic and they are not always convenient to access. RFID can be highly secure (as with contactless payment systems - Oyster, skiing) and easily read.

However to get the most from this technology integrated thinking is needed, copy typing data on admissions for example is one area where errors can occur and be propagated in the system, however there are few organisations willing or able to take a systems view of the issues.

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