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Quality in practice: implementation of hospital guidelines for patient identification in Malawi.

Latham, Tom, Malomboza, Olive, Nyirenda, Loveness, Ashford, Paul, Emmanuel, Jean, M'baya, Bridon and Bates, Imeld# ORCID: (2012) 'Quality in practice: implementation of hospital guidelines for patient identification in Malawi.'. International Journal for Quality in Health Care, Vol 24, Issue 6, pp. 626-633.

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QUALITY PROBLEM OR ISSUE: Patient identification in a teaching hospital in Malawi. Initial assessment 34% of hospital staff recalled a misidentification event in the preceding year; less than 10% of staff described the use of unique patient identifiers other than name when taking blood samples and 98% of laboratory requests included no identifiers other than name.


Provision of wristbands, educational materials, workshops and distribution of written materials to promote the new guidelines with regular monitoring.


At 5 months 65% of in-patients wore wristbands compliant with WHO identification guidelines and 55% of cross-match forms used a second identifier. Only 10% of non-cross-match forms had a second identifier. The use of recommended bedside identification procedures was rarely observed. Guidelines were welcomed by both staff and patients; identification wristbands were found useful in difficult identification situations. Lack of time, staffing and unimportance of procedures were given as reasons for not following guidelines.


Identification procedures can be rapidly introduced in a developing world context in a manner acceptable to patients and staff. Tangible tools such as wristbands appeared easier to implement than changing practice by education. Recommendations for wider implementation include increased engagement of patients in addition to healthcare and management staff; use of rejection criteria for inadequately labeled samples; generating further evidence about the prevalence, type and consequences of patient misidentification events.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WX Hospitals and Other Health Facilities > Hospital Administration > WX 150 General works
WX Hospitals and Other Health Facilities > Clinical Departments and Units > WX 207 Clinical and pathological laboratories
Faculty: Department: Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):
Depositing User: Rachel Dominguez
Date Deposited: 10 May 2013 10:15
Last Modified: 22 Oct 2019 08:22


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