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Preventing Infant Misfeeds

Point-of-care mobile authentication in the NICU

Nurse routinely follow patient identification and authentication procedures to ensure patient safety at virtually every point of care-from the admissions desk and emergency department, to the medications dispensed at the bedside, to the pharmacy, diagnostic labs and operating rooms.

Mobile systems have saved time and significantly reduced the risk of misidentification and interruptions that can lead to human error.  Verifying clear, legible human- and machine-readable data-both barcodes and text- from both the patient's wristband and the drug or sample label helps to ensure accurate patient ID as required by The Joint Commissions (JCAHCO) regulations and the five rights of patients: the right patient, right drug, right dose, right route, and right time.

Mobile Solutions for Accurate Neonatal Feeding
With the increased use of mobile devices such as smartphones and tablets, software developers are starting to create new ID and verification applications designed expressly for clinical use on mobile platforms. One such app is currently transforming the way in which infant milk bottles are prepared and administered in one of California's largest Neonatal ICU Units (NICU) in a hospital serving Los Angeles and San Bernardino counties. The NICU has 55 beds and is supported by a staff of 160 nurses.

feeding infant with bottleThe app was developed on-site to meet specific patient safety requirements and to improve patient safety by preventing breast milk misfeeds.  While accurate patient and bottle identification has always been paramount to the nursing staff, the volume of milk stored in NICU refrigerators for mothers who sometimes are no longer admitted to the hospital was growing. This growth created increased interest in sourcing and implementing a more advanced mobile point-of-care labeling and identification solution for this critical patient group. In addition to premature infants, the NICU also cares for full-term babies born with conditions requiring specialized care. In both cases, the tiny patients' delicate systems can be harmed or compromised by being fed the wrong mother's milk.

The app has proven to work smoothly and efficiently.  After secure login verification on a smartphone, the NICU nurse scans the baby's wristband, prints matching labels, and fills bottles with the mother's milk. Just before feeding, the nurse scans both labels to verify that the right bottle is about to be fed to the right baby. The entire process is integrated into the hospital's existing EMR system, so every step is recorded for future viewing and reporting.  Since implementing Mother's Milk, the hospital reports that more than 70,000 correct verifications have been made and over 480 potential misfeeds prevented.

Mobile at the Point-of-Care: The Wave of the Future
While a majority of hospitals already have barcode scanning and label printing systems, most are not using mobile technology to its full potential.  With newer, more innovative mobile applications now in the marketplace, physicians, nurses and hospital administrators are being empowered to improve the quality of patient care and increase workflow efficiency right at the point-of-care. The same type of mobile authentication and verification software apps can also be deployed to prevent errors and mismatches in other hospital areas.  For example, when nurses administer blood, medications and nutrition to patients at the bedside or in a fast-moving ED. Or when nurses ensure results from biopsy samples taken in the surgical suite the lab for analysis are returned  to the right suite and right patient.

Best of all, the latest mobile software apps can easily be integrated into a hospital's EMR system to provide data capture, analysis and reporting for clinicians, hospital administrators and other authorized professionals. Keeping complete and accurate electronic records of patient care processes and procedures not only increases patient safety, but also reduces risk and ensures compliance with existing standards of care.

David Crist is president of Brother Mobile Solutions

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