Closing the safety loop: evaluation of the National Patient Safety Agency's guidance regarding wristband identification of hospital inpatients

Rationale, aims and objectives  Wristbands are essential for accurate patient identification. Some evidence suggests that missing wristbands is not an infrequent occurrence in acute hospitals. The National Patient Safety Agency (NPSA) has developed guidance on patient identification for hospitals in England and Wales. Here we report an evaluation of the uptake of the guidance.
Method  The evaluation was designed as a 'pre–post' intervention survey. Fifty hospitals (response rate 67%) responded to the 'pre-guidance' part and 40 hospitals (response rate 43%) responded to the 'post-guidance' part.
Results  The majority of the hospitals use wristbands to identify inpatients. Fifty-eight per cent of the hospitals in the 'pre-guidance' survey and 50% of them in the 'post-guidance' survey reported not having a patient identification policy before receiving the guidance. Only one hospital reported not having developed such a policy in the 'post-guidance' survey. Ninety-eight per cent of the hospitals reported that their policies are consistent with the guidance. Relevant training to staff is provided in about a quarter of the organizations, both before and after the guidance. Problems in implementing the guidance were reported by 23% of the hospitals, and included difficulties with staff or patient attitudes, or with the guidance itself, or difficulty to identify a lead staff member.
Conclusion  Overall, implementation of NPSA guidance regarding inpatient identification was satisfactory. The reported problems should be taken into account, as they likely apply to a range of patient safety interventions. Limitations of evaluating intervention uptake, rather than efficacy, and relying on self-report are discussed.