Alreja Gaurav, Setia Namrata, Nichols James, Pantanowitz Liron
Department of Internal Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
J Pathol Inform. 2011;2:22. doi: 10.4103/2153-3539.80718. Epub 2011 May 11.
Patient identification (ID) errors in point-of-care testing (POCT) can cause test results to be transferred to the wrong patient's chart or prevent results from being transmitted and reported. Despite the implementation of patient barcoding and ongoing operator training at our institution, patient ID errors still occur with glucose POCT. The aim of this study was to develop a solution to reduce identification errors with POCT.
Glucose POCT was performed by approximately 2,400 clinical operators throughout our health system. Patients are identified by scanning in wristband barcodes or by manual data entry using portable glucose meters. Meters are docked to upload data to a database server which then transmits data to any medical record matching the financial number of the test result. With a new model, meters connect to an interface manager where the patient ID (a nine-digit account number) is checked against patient registration data from admission, discharge, and transfer (ADT) feeds and only matched results are transferred to the patient's electronic medical record. With the new process, the patient ID is checked prior to testing, and testing is prevented until ID errors are resolved.
When averaged over a period of a month, ID errors were reduced to 3 errors/month (0.015%) in comparison with 61.5 errors/month (0.319%) before implementing the new meters.
Patient ID errors may occur with glucose POCT despite patient barcoding. The verification of patient identification should ideally take place at the bedside before testing occurs so that the errors can be addressed in real time. The introduction of an ADT feed directly to glucose meters reduced patient ID errors in POCT.
即时检验(POCT)中的患者识别错误可能导致检测结果被传输到错误患者的病历中,或者导致结果无法传输和报告。尽管我们机构实施了患者条形码制度并持续对操作人员进行培训,但葡萄糖POCT仍会出现患者识别错误。本研究的目的是开发一种解决方案,以减少POCT中的识别错误。
我们医疗系统中约2400名临床操作人员进行葡萄糖POCT。通过扫描腕带条形码或使用便携式血糖仪手动输入数据来识别患者。血糖仪对接后将数据上传到数据库服务器,然后服务器将数据传输到与检测结果财务编号匹配的任何病历中。采用新模型后,血糖仪连接到接口管理器,在该管理器中,将患者ID(一个九位账号)与入院、出院和转科(ADT)信息中的患者登记数据进行核对,只有匹配的结果才会传输到患者的电子病历中。采用新流程后,在检测前会检查患者ID,在识别错误解决之前会阻止检测。
在一个月的时间段内进行平均计算,与使用新血糖仪之前每月61.5次错误(0.319%)相比,识别错误减少到每月3次错误(0.015%)。
尽管有患者条形码制度,葡萄糖POCT仍可能出现患者识别错误。理想情况下,应在床边检测前进行患者身份验证,以便能实时解决错误。直接将ADT信息引入血糖仪可减少POCT中的患者识别错误。