Electronic identification increases patient safety

The error-free identification of the patient is the foundation of patient safety; on the other hand, errors in identification may cause significant harm to patients. Research shows that electronic identification improves patient safety.

According to the World Health Organization, patient misidentification is a common avoidable cause of patient injury¹, and the adverse effects caused by patient misidentification are estimated to be very significant internationally². Research on this topic has also been carried out in Finland and, to provide an example, patient misidentification was found to be the root cause of about a third of adverse events related to radiation use³.

At worst, patient misidentification can cause significant risks to patient safety and patient harm, such as the wrong procedure (e.g., surgery) being performed on the patient.^1,²However, errors related to identification are always avoidable and the risk of patient misidentification can be significantly reduced with the right measures⁴^,⁵.

The term “patient identification” refers to the processes and methods for ensuring that the correct patient receives the treatment, care or service intended for them and for relaying the information about the patient’s identity accurately and reliably throughout the treatment process.^{5, 6}

Error-free identification is the foundation of patient safety

Error-free identification is the foundation of patient safety in all examination and treatment situations². The principles of error-free identification include, for example, the patient’s identity is verified using at least two identifiers, neither of which may be the patient’s room or bed number. The identities of patients who are familiar to the nurse should also be verified.²^,⁴

All patients being cared for in a ward must have an ID wristband. There is strong research evidence that ID wristbands with a barcode decrease patient misidentification.² According to the Finnish Centre for Client and Patient Safety, the patient’s identity should be confirmed electronically by scanning the barcode on the wristband or another similar piece of identifying information directly into the patient information system or another system suitable for electronic identification, if possible.⁵ WHO also recommends using technological solutions to help with identification in order to avoid errors⁴.

Error-free identification is especially important when it comes to medication

Error-free identification of the patient is especially important when it comes to medication. The medication process is prone to errors⁷, and up to 10% of reported medication safety incidents are related to errors in the identification of the customer or patient⁸.Electronic identification is also useful here: barcode-assisted medication administration processes have been found to increase safety and decrease medication administration errors by up to 43.5%¹⁰.

In particular for the closed loop medication process, it is key that the patient is identified electronically at all critical stages of the medication process. The Finnish Ministry of Social Affairs and Health’s working group memorandum on the closed loop medication process states that, during hospital care, the administration of all medications, including regular medications, must be recorded. The person who administeres the medication makes an administration entry in real time using, for example, a mobile device.¹¹

The wellbeing services county of Kainuu, Finland, encourages staff to use the Medanets mobile app instead of a computer to make medication administration entries, as the patient is identified electronically when the app is used.

Sources:

1. WHO (2023): Patient safety. Accessed 22.9.2023.

2. Hotus (2021): Onnistu laboratorionäytteissä – suositus tutkimusten valinnasta, potilaan tunnistamisesta ja ohjaamisesta. Hotus-hoitosuositus.

3. Tarkiainen et al. (2020): Adverse events due to unnecessary radiation exposure in medical imaging reported in Finland. Radiography 26(4): E195-E200.

4. WHO (2007): Patient Identification. Patient Safety Solutions, volume 1, solution 2.

5. Finnish Centre for Client and Patient Safety (2021): Kuvaus tunnistamisen menettelyistä.

6. ECRI institute (2016). Patient Identification: Executive Summary.

7. Elliott et al. (2021): Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality of Safety 30: 96-105.

8. Duodecim oppiportti (2022): Potilaan tunnistamisen hyvät käytännöt. Accessed 22.9.2023.

9. Holden et al. (2011): That’s nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of care. International Journal of Industrial Ergonomics 41(4): 370-379.

10. Thompson et al. (2018): Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2(4):432-351.