Walley Susan Chu, Berger Stephanie, Harris Yolanda, Gallizzi Gina, Hayes Leslie
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Hosp Pediatr. 2013 Apr;3(2):108-17. doi: 10.1542/hpeds.2012-0075.
Patient identification (ID) bands are an essential component in patient ID. Quality improvement methodology has been applied as a model to reduce ID band errors although previous studies have not addressed standardization of ID bands. Our specific aim was to decrease ID band errors by 50% in a 12-month period.
The Six Sigma DMAIC (define, measure, analyze, improve, and control) quality improvement model was the framework for this study. ID bands at a tertiary care pediatric hospital were audited from January 2011 to January 2012 with continued audits to June 2012 to confirm the new process was in control. After analysis, the major improvement strategy implemented was standardization of styles of ID bands and labels. Additional interventions included educational initiatives regarding the new ID band processes and disseminating institutional and nursing unit data.
A total of 4556 ID bands were audited with a preimprovement ID band error average rate of 9.2%. Significant variation in the ID band process was observed, including styles of ID bands. Interventions were focused on standardization of the ID band and labels. The ID band error rate improved to 5.2% in 9 months (95% confidence interval: 2.5-5.5; P < .001) and was maintained for 8 months.
Standardization of ID bands and labels in conjunction with other interventions resulted in a statistical decrease in ID band error rates. This decrease in ID band error rates was maintained over the subsequent 8 months.
患者识别腕带是患者身份识别的重要组成部分。尽管以往研究未涉及识别腕带的标准化问题,但质量改进方法已被用作减少识别腕带错误的模型。我们的具体目标是在12个月内将识别腕带错误减少50%。
六西格玛DMAIC(定义、测量、分析、改进和控制)质量改进模型是本研究的框架。对一家三级护理儿童医院2011年1月至2012年1月期间的识别腕带进行审核,并持续审核至2012年6月,以确认新流程处于受控状态。经过分析,实施的主要改进策略是识别腕带和标签样式的标准化。其他干预措施包括开展关于新识别腕带流程的教育活动以及传播机构和护理单元的数据。
共审核了4556个识别腕带,改进前识别腕带错误平均率为9.2%。观察到识别腕带流程存在显著差异,包括识别腕带的样式。干预措施侧重于识别腕带和标签的标准化。识别腕带错误率在9个月内降至5.2%(95%置信区间:2.5 - 5.5;P <.001),并持续了8个月。
识别腕带和标签的标准化与其他干预措施相结合,使识别腕带错误率在统计学上有所下降。识别腕带错误率的这种下降在随后的8个月内得以维持。