Documentation of unidentified POC testing in the Emergency Department

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Our hospital region is discussing how best to reconcile POC testing using emergency barcodes for patients that do not yet have chart labels for test performance. Some of our ED managers are extremely helpful in navigating new admit charts and providing us MRNs  if their RNs have notated test results, but I am concerned that this does not provide us with enough documentation and could lead to misidentification. Have any of you found a process that works with your own EDs? 

Thank you!

6 Replies

Brandon, 

We require a form to be submitted to us to identify the patient within the same shift. 
For those who do not submit it, there are two ways that the patient information can be ascertained. 

I call into the ER to see if the current charge nurse can text the operator. There are certain reports that the nursing side can generate from the HIS that will give the census and it can be found that way. 

If the unit (operator) does not submit the form to us within the same shift, they are removed from the POC device. 

This seldom happens.  Due to the hand off communication on the nursing side of the world, they almost immediately know who the patient information I am seeking.  

This works for us-I have 5 ER areas that use the ISTAT. Soon to be 6......

Deanna 



Patient ID Correction Form.docx
Hi Brandon
We are a small community hospital with a busy ED.  There is a crashcart911 barcode on all the crash carts that staff scan.  They can either free text 2- patient identifiers into the meter or email me and or the assistant ED manager.  If that doesn't happen review the ED patient log for day/time.  Finally, if all else fails I send the attached form to operator and ED manager to reconcile. They are given 4 weeks (this may be changing).
Rarely do they go unidentified.
This is POC CAP QA monitor for our hospital

Hi Brandon,

For our ED, the POC office creates barcodes with specific identifiers that never get repeated (000001ED, 000002ED etc.) and place these barcodes onto specific slips of paper. When a patient is needing POC testing before they are registered in the EMR the ED staff are trained to grab one of these slips and use the designated barcode on the slip of paper was their Patient ID in the POC device. Then they are to write the POC result on the slip of paper and once the patient is registered, they place a chart label onto this slip of paper as well. So in one slip we have the result, a chart label, and the unique barcode that was used in the device. The staff are then supposed to place these slips into the mailbox of the ED POC Lead. Then the POC office reaches out to the ED POC Lead to obtain the patient information and send the result to the patient's chart. These are typically POC glucose tests we are talking about. Our blood gas/electrolyte testing in the ED always has a chart or lab label because they shouldn't be drawing blood from the patient until the patient is registered in the EMR.  For the inpatient units, we have similar slips of paper with similar unique identifier barcodes onto them (created by the POC office) - for inpatients these are used typically for Codes when the phlebotomist is not able to get a chart label from the patient team, but the team is needing i-stat testing on the patient. These barcodes are (0001CODE, 00002CODE etc.) The phlebotomist is in charge of getting a chart label (or two patient identifiers) before leaving the code. The phlebotomist places the patient information and the i-stat print out onto the slip of paper with the CODE barcode on it and they send it to the main laboratory. The POC office picks up these slips M-F and rectifies the results and sends them to the patient's chart. We keep these slips of paper in the POC office in case an inspector was ever to ask. 


We currently follow this: The emergency POC tests are ran on a "9111111111" patient ID and then the user is required to submit a Correction form to identify the test and have it pushed to the correct patients chart.  We email staff that do not submit the form while CC'ing their manager.  We get about 30-50% compliance with this.

I recently reviewed a system that did this: They use prebuild "John Doe" accounts created for these emergencies where the user can not wait for registration to do their thing and run the POC tests using this temp account.   Once the patient is identified and an actual account is created for the patient, registration *merges* the temp account and the actual account.... this resolves the user from having to do extra steps.  This also pretty much nets a 100% successful documentation rate for the system for this senerio.
  • I am hoping/working to convert to this system but it requires multiple depts to change their workflow, not an easy task here.

Yes, similar to everyone else here.  We have a form they must complete that has the emergency ID used with all the follow up information of who the result belongs to as well as date, time, result, and operator who performed the test.  POC Lab picks up these forms M-F.  As long as all the information matches up, we will send the results to the chart.  If they fail to provide the form filled out, the operator and the leaders are emailed to obtain the information.  We usually get it if that happens!

I very much appreciate everyone's input! 

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Brandon Doe
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