Connect with us

Clinical Updates

Unidentified patients should be given ‘randomly generated names’

The risk of misidentification is usually higher when several unidentified patients arrive together such as after an accident, or in mass casualty situations.

Published

on

wristband
Adobe / indeMedia

Unidentified patients are to be assigned a randomly generated name, hospital number and an approximate date of birth.

NHS Improvement has said that patients who are unable or unwilling to give their identity should no longer be identified as ‘unknown male’ or ‘unknown female’ as this can increase the chance of clinical errors.

Often patients attending Emergency Departments are unable or unwilling to give their identity – this may be due to unconscious or critical illness, people with a mental health condition or delirium, and people affected by drink or drugs.

Advertisement

Presently, these patients are usually identified as ‘unknown male’ or ‘unknown female’ and assigned a generic date of birth.

However, an NHS Patient Safety Alert states this system risks the misidentification of these patients when compared to other patients for whom first name and surname, unique NHS number and individual date of birth are all used.

Increased risk of misidentification.

Going on to add that the risk of misidentification is usually higher when several unidentified patients arrive together such as after an accident, or in mass casualty situations.

The new guidelines state that unidentified patients should now be assigned a randomly generated name, hospital number and given an estimated date of birth.

The regulator suggests NHS organisations randomly generate combinations of first and surnames using the phonetic alphabet, for dates of births combine the 1st of January with an estimated year of birth and temporary hospitals numbers are random rather than sequential.

NHS Improvement states that “giving a unique identity to each unknown patient ensures safe and prompt diagnostic testing and treatment. For example, it helps prevent allocating blood test results to the wrong patient and fatal ABO incompatible blood transfusion.”

The alert states that changes should be implemented by NHS organisations as soon as possible.

Advertisement

Clinical Care

Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

Published

on

Nurse with patient in bed

Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

Advertisement

Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

Continue Reading

Clinical Updates

Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

Published

on

Observations

A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

Advertisement

Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

Continue Reading

POPULAR