To compare the incidence of wrong-patient orders among obstetric patients and reproductive-aged women admitted to medical–surgical units. Between January 1, 2016, and December 31, 2018, an observational research was undertaken at a big health system in New York. The primary result was the identification of near-miss wrong-patient orders using the National Quality Forum-endorsed Wrong-Patient Retract-and-Reorder metric. The unit of analysis was the order session, and all electronic orders issued for eligible patients throughout the research period were retrieved retrospectively from the health system data warehouse. Multilevel logistic regression models were used to calculate odds ratios (ORs) and 95 percent confidence intervals (CIs) evaluating the likelihood of retract-and-reorder occurrences in obstetric and medical–surgical units generally, as well as in subgroups defined by clinician type and order time. During the research period, 1,329,463 order sessions were placed, comprising 676,643 obstetric order sessions and 652,820 medical–surgical order sessions. The incidence of retract-and-reorder occurrences in obstetric units was 79.5 per 100,000 order sessions, which was substantially higher than the rate in the general medical–surgical population of 42.3 per 100,000 order sessions. When compared to advanced practise doctors, the rate of obstetric retract-and-reorder events was substantially greater for attending physicians and house staff. Error rates did not change significantly between day and night shifts.
Order mistakes were more common on obstetric units than on medical–surgical units. System solutions that have been demonstrated to reduce these occurrences in other high-risk specialities should be investigated in obstetrics to provide better maternity care.
Reference: https://journals.lww.com/greenjournal/Fulltext/2021/08000/Wrong_Patient_Orders_in_Obstetrics.9.aspx
