L’identitovigilance en psychiatrie

Abstract

Background

The accurate identification of patients is a serious global healthcare concern. Errors in this regard may have egregious consequences, such as administering the wrong medication to a patient, using an incorrect blood type for a blood transfusion, or assigning newborns to the wrong parents. To reduce the occurrence of these types of incidents, identity bracelets are commonly issued to patients upon their admission into a hospital setting. However, just how diligently this procedure is followed by staff, and how aware patients are of the importance of an identity bracelet as part of their hospital admission process, is rarely quantified. Identity bracelets are particularly important in psychiatry due to the nature of severe mental disorders, which can make it difficult or even impossible for the patients to confirm their identity. However, bracelets can be refused by psychiatric patients and their use can cause reluctance among caregivers.

Objectives

This study aims to assess patients’ and staff's awareness, opinion, and perception of the protocols of assignment of identity bracelets in a department of a public psychiatric hospital (Ville Évrard hospital, France).

Materials and methods

In this pilot, single-center study, both patients and staff members completed either a paper- or web-based questionnaire. The questionnaires focused on their understanding and perception of patient identification procedures, particularly the use of identity bracelets.

Results

(1) Regarding the staff survey, 42 participants, aged 20 to 65 years, were included: 26.2% were doctors, 21.4% secretaries, 19.0% nurses, 9.5% psychologists, 7.1% social workers, and 16.7% from other professions. On average (standard deviation), these staff members had worked in the Ville Évrard hospital for 6.9 years (7.4). Only 19.0% of respondents reported having a good or excellent understanding of the patient identification procedure. However, 72.5% considered the procedure to be useful. Notably, the majority of staff members (66.7%) reported that identity bracelets were not used in their department. (2) Regarding the patient survey, a total of 68 patients participated. For the majority of patients (65.7%), identity monitoring presented no disadvantages, and some even felt reassured by it. However, a small minority considered it was a means of data collection (2.9%) and a surveillance system (2.9%) that infringed upon their freedom. The majority of patients was familiar with identity bracelets (88.2%) and held a positive opinion of them (56.7%). However, only a minority of patients (10.3%) reported being offered the bracelet during their psychiatric hospitalization. Interestingly, 80.9% of these same patients reported having worn a bracelet while at general medical care services. At the end of the questionnaire, patients recommended two things: discreetly calling patients aside, and informing them about the benefits of a bracelet before issuing one.