Emergency ID use followup
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Hi POCT experts,
I would love to ask for your input on our current process for using an emergency ID.
Background: We currently have an Emergency ID reserved for ED trauma patient prior to registration. However, the emergency ID has been used for employee or patient's family in various situations. Per our policy, the emergency ID can be used for employees or patient's family only when it is authorized by an MD. After testing, the affected employees or patient's family is supposed to go to ED or employee health so we can properly transfer the results to their charts. In practice, this is not being followed at all. We are seeing multiple occasions each month the ID is used for the employees or patient's family without authorization, without following up, and without any communication with POCT team.
I am wondering whether our current practice is based on any CAP or CLIA requirements or checklist items, I wasn't able to pinpoint to any checklist items. Could anyone share your protocol at your practices? The only idea I got is to create a form requires authorized MD's signature, but I would appreciate hearing how others manage this.
Thanks,
Xu Li
I would love to ask for your input on our current process for using an emergency ID.
Background: We currently have an Emergency ID reserved for ED trauma patient prior to registration. However, the emergency ID has been used for employee or patient's family in various situations. Per our policy, the emergency ID can be used for employees or patient's family only when it is authorized by an MD. After testing, the affected employees or patient's family is supposed to go to ED or employee health so we can properly transfer the results to their charts. In practice, this is not being followed at all. We are seeing multiple occasions each month the ID is used for the employees or patient's family without authorization, without following up, and without any communication with POCT team.
I am wondering whether our current practice is based on any CAP or CLIA requirements or checklist items, I wasn't able to pinpoint to any checklist items. Could anyone share your protocol at your practices? The only idea I got is to create a form requires authorized MD's signature, but I would appreciate hearing how others manage this.
Thanks,
Xu Li
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Please review the following thread on this site:
Good Luck
For our situations, those ID usages are being used for non-patient and not limited to ED area.
In our hospital we use what we call a "universal ID" in the ER mainly but other sites are allowed to use it as well. The ER has a log sheet that they fill in the information for the patient when using the ID and scan to POC dept nightly for reconcilliation. If the floors use the universal ID then they are to email POC with patient information and when they don't then they get an email from me asking for the information. We discourage the use of meters for employees or family members and redirect them to personal use glucometers, urgent care or ER. For our purposes, 111111111111 is used for unregistered patients, 000000000000 for the rapid response team and 9999999999 for training purposes. We use the statstrip meters here. Feel free to reach out if you have any other questions to kmullen@signature-healthcare.org.
Unfortunately, this is one of those POC "battles" that are very difficult to win and something we all struggle with. We all have to provide a means of performing a POC test like glucose when the appropriate patient ID material is legitimately unavailable. However, that means that there will be times it's used inappropriately, like what you described. Providing a "home use" meter that takes the testing out of your responsibility is good option, but it still doesn't prevent them from using the hospital meter. All you can really do is loop in operator supervisors/managers/leads when these incidents present so that the message can come from their own reporting chain that it is unauthorized use of your Emergency Patient ID. Consider keeping statistics via your middleware on just how many times it occurs on each unit and by whom so you can come back with actual data. A responsible manager should in turn counsel their staff.
We have similar procedures for unregistered patients. If the testing operator does not email us full patient details, we consider that an "improper ID". For process improvement, we initiated an escalation from notifying the operator, manager, to revoking access and have added improper IDs to our POC QI report that is sent to all departments monthly.
I understand that test orders need to be from an authorized requestor but having a signature is not going to be helpful if the problem is the operator not providing/confirming patient identification.
This is definitely hard to manage. I follow up on every POCT unknown ID and if its done on an employee or visitor with no rapid response or code called we communicate with the manager and the staff member and re-educate that POC testing must have a provider order or protocol in place to perform. Additionally, in some cases this is personal use of the device which is never permitted. Obviously there are special situations which may require testing to be done without the order, but these should be rare.
There is a CAP standard below.
GEN.40930 | X | 2 | Authorized Requestor | The laboratory has a mechanism to ensure that specimens are analyzed only at the request of an authorized person.
Hope this helps.
Brian