Authors (including presenting author) :
Tam MK , Leung TF , Chu KW , Wong YH
Affiliation :
Operating Room, Department of Anaesthesiology, Pain Management and Operating Service, United Christian Hospital
Introduction :
Accurate Surgical specimen management is an important responsibility of perioperative nurses and essential to ensure patient safety. In the United Christian Hospital Operating Room (OR), manual entry of investigation requisition form and specimen labelling had been used for decade. However, problems include misspelling and other errors associated with handwriting, incorrect order entry sometimes happened. Despite, potential risk of patient misidentification had been identified. Therefore, a computerized Barcode Pathology Specimen System, under Hospital Authority Generic Clinical Request System was developed and implemented for enhancing specimen management in OR.
Objectives :
• To ensure correct investigation ordering
• To ensure accurate patient identification
• To improve efficiency in specimen handling
Methodology :
Under the system, doctor first enter his/her investigation orders and printout the requisition form. Nurse identity the patient and scan the form against patient’s wristband, when matched, barcode labels with patient identification and laboratory order information will be generated for labelling specimens. For specimens require documentation (e.g. photo), doctor have to attach it on the requisition form, mark it in the system and send for pathology examination.
Result & Outcome :
Post intervention survey was implemented in December 2021. The evaluation framework was based on the Multidimensional Model of Information Evaluation by DeLone and Maclean. 6-points Likert scale (from 0 – Strongly disagree to 5 – Strongly agree) was used for respondents to indicate their level of agreement with the questions.
77 returns were received (50 from nurses, 22 from doctors and 5 from pathology colleagues). Results showed optimistic responses from respondents. Nurses perceived the barcode scanning system ensuring accurate patient and specimen identification (Mean =4.1). Pathologists perceived it could help them identifying pathology specimen correctly (Mean=4.6) and improve their work efficiency (Mean=4.8). Before implementation an average time required for data entry by pathology colleagues each patient was 5 minutes; after implementation was 4 seconds. Doctors agreed the system ensure correct investigation ordering (Mean=4.3). All perceived the printout requisition form and barcode label display information clearly (Mean = 3.8).
Year before implementation, there were 28 specimen incidents related to misspelling or handwriting, incorrect ordering and unclear label content were recorded. After implementation, no incident was occurred.
Overall, all respondents felt satisfactory for the implementation (Mean=3.9) and commented that was innovative (Mean=3.6).
