Addressing Patient Safety Issues at Independence Medical Center

This report addresses a patient safety issue at the Independence Medical Center, where two patients with similar names and birthdates pose a risk of identification errors. The report identifies potential risks, including assessment and medication errors, and their impact on patients, employees, and the organization. It highlights the roles of regulatory agencies and the patient safety officer in mitigating these risks. Evidence-based best practices, such as using medical numbering and avoiding leading questions, are recommended. The report concludes that proactive measures are crucial to prevent adverse outcomes and ensure patient safety. References to supporting literature are provided.

Running head: ADDRESSING A PATIENT SAFETY ISSUE
Addressing a Patient Safety Issue
Your Name
BHA4004
Assignment u02a1
Date:
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ADDRESSING A PATIENT SAFETY ISSUE
In this portion of the assignment, effective risk management principles has been
applied to the above mentioned incident in order to help the organization achieve its
safety and quality goals.
Risk Description
At the Independence Medical Center, the patient safety officer, while conducting her
daily round noticed that there are two healthcare service users with similar name “B.
Moore” and “B.R. Moore” in rooms directly across each other. Along with name, the
patients also have similar birthdates. Moore was born on 8/11/05 and B. R. on 11/8/05.
Hence there prevails a chance of patient identification error which can impose negative
impact on the health of both the patients.
Risks if Threats not Addressed
In case the threat of patient identification error is not addressed on an immediate basis
the following incidents may take place:
Risk of the patient
1. Assessment error: Considering the fact that the health condition and health issue of
the patients are different, confusing one of the patient as another can result in
assessment error. Nurses can confuse one patent as another and the assessment
report of one patent can be confused as the assessment report of another. This
eventually will lead to medication error (Lippi et al., 2017).
2. Medication error: provision of medication to one of the patent, by wrongly identifying
him as another will not only reduce the chance of his recovery but will deteriorate
his health condition. In case of provision of inappropriate medication to any of the
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ADDRESSING A PATIENT SAFETY ISSUE
patent for a prolonged amount of time, there even exist a risk of fatal results like
death of the patients.
Risk of the Employees
1. Considering the fact that the nurses has already been warned about the chances of
patent identification error, further mistakes leading to wrong medication provision
may result in severe punishment, suspension a well as termination of the
responsible employee or employees.
2. Also in case of severe heath deterioration of the patient due to prolonged provition
of wrong medication, legal action will be taken against the responsible employee or
employees
Risk of the organization
Legal action car be taken by the patient’s family on the organization resulting in
deterioration of the reputation as well as revenue of the organization.
Regulatory Agency Role and Impact
The role of the regulatory agency is to identify this type of risk in future so that
the same can be prevented.
One of the most effective strategies includes analyzing the incident report Data.
Considering the fact that an incident report data contains all the details of the patient,
any discrepancy in the report will help the nurse to identify the patient identification error
in future (Lippi et al., 2017).
Implementing these strategies will reduce the risk of such threats in future.
Patient Safety Officer’s Role
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ADDRESSING A PATIENT SAFETY ISSUE
The role of the patient safety officer is to implement effective strategies to
mitigate the risk in future.
In order to deal with such patient identification error, patients having similar name must
be kept at different floors. Different set of nurses will be recruited for the patients and
regular monitoring of whether any kind of patient identification error is taking place or
not will be done through verification of the reports (van Dongen-Lases et al., 2016).
Along with this patient identifiers will be used for confirming the identity of the patient
before beginning each encounter. The patient identifiers to be used can involve the
name of the patient, his or her date of birth, unique hospital ID number, Social Security
number or photo
Evidence-Based Best Practice Recommendations
1. One of the evidence based best practice includes identifying the patient on the
behalf of medical numbering along with his or her name and birth dates. This will
help the healthcare service providers to multiple check , but will also prevent
patient identification error.
2. The heath care service providers should avoid leading the patients while asking
for identification. For instance, patent should be asked “tell your full name.”
instead of “ Are you Mr. Moore?” this is because, patients often remains
disoriented in the hospital.
3. The nurses should always confirm identification of the patient before labeling
their specimen container or submitting their reports.
Conclusion
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ADDRESSING A PATIENT SAFETY ISSUE
From the above discussion, it can be concluded that the patient identification error
possess the potential to result in adverse impact not only on the patent but also o the
employees as well as the organization (Manit et al., 2017). Hence, it is highly crucial for
the nurses of the Independence Medical Center to take effective steps so that the
reports or specimen of the patients don’t get mixed up.
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ADDRESSING A PATIENT SAFETY ISSUE
References
Manit, J., Bremer, C., Schweikard, A., & Ernst, F. (2017). Patient identification
using a near-infrared laser scanner. In Medical Imaging 2017: Image-Guided
Procedures, Robotic Interventions, and Modeling (Vol. 10135, p. 101352L). International
Society for Optics and Photonics.
Lippi, G., Mattiuzzi, C., Bovo, C., & Favaloro, E. J. (2017). Managing the patient
identification crisis in healthcare and laboratory medicine. Clinical biochemistry, 50(10-
11), 562-567.
van Dongen-Lases, E. C., Cornes, M. P., Grankvist, K., Ibarz, M., Kristensen, G.
B., Lippi, G., ... & Simundic, A. M. (2016). Patient identification and tube labelling–a call
for harmonisation. Clinical Chemistry and Laboratory Medicine (CCLM), 54(7), 1141-
1145.
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