Acceptability of pictographs as a novel patient identifier to improve patient safety in the neonatal intensive care unit.

As part of a randomized controlled trial on the use of pictographs (images used in lieu of a patient photo) embedded in the electronic health record to reduce wrong-patient errors in the neonatal intensive care unit (NICU), we conducted a series of surveys of parents, providers and nurses in the NICU. Data from survey responses were thematically analyzed and categorized. We found that in all groups, there was very high awareness of the intended purpose of the pictographs; however, the perception of providers and nurses about the effectiveness of pictographs was not as strong. While several providers and nurses acknowledged that pictographs can or have helped them avoid wrong-patient errors when caring for multiple birth infants (such as twins), many nurses believed that their current practice of the use of two patient identifiers was sufficient, and pictographs were not useful. Parents reported that pictographs improved their experience of care.