Henneman Philip L, Fisher Donald L, Henneman Elizabeth A, Pham Tuan A, Mei Yi Y, Talati Rakesh, Nathanson Brian H, Roche Joan
Department of Emergency Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
Acad Emerg Med. 2008 Jul;15(7):641-8. doi: 10.1111/j.1553-2712.2008.00148.x.
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.
通过使用两个标识符来改进患者识别是联合委员会的一项安全目标。合适的标识符包括姓名、出生日期（DOB）或病历号（MRN）。
目的是确定在计算机化医嘱录入（CPOE）过程中核实患者身份的频率。
这是一项使用眼动追踪设备的模拟场景前瞻性研究。要求医疗服务提供者查看10份病历（场景），从计算机字母列表中选择患者并下达检查医嘱。与计算机相比，有两个场景存在身份识别错误（出生日期错误或姓氏拼写错误），第三个场景存在潜在错误（字母列表中第二个姓氏相同的患者）。提供者不知道重点是患者身份识别。核实患者身份定义为在计算机上查看姓名以及出生日期或病历号。
当有第二个姓氏相同的患者时，25名提供者中有25名（100%；95%置信区间[CI]=86%至100%）选择了正确的患者。25名中有2名（8%；95%CI=1%至26%）注意到出生日期错误；其余23名在错误的患者身上下达了检查医嘱。25名中有1名（4%，95%CI=0%至20%）注意到姓氏错误；12名在错误的患者身上下达了检查医嘱。在从字母列表中选择患者之前，没有参与者（0%，0/107；95%CI=0%至3%）通过查看病历号来核实患者身份。23%（45/200；95%CI=17%至29%）在下达检查医嘱之前核实了患者身份。
医疗服务提供者在CPOE过程中经常忽略身份识别错误，很少使用两个标识符来核实患者身份。
