Distinct newborn names cut NICU medical error rates in Montefiore study

By Frank Irving

A simple but distinct naming convention could help prevent medical errors in hospital neonatal intensive care units, according to a study conducted by researchers at the Montefiore Health System in New York and published online in Pediatrics ahead of its August issue.

When parents haven't decided on a name for their newborn child, some hospitals assign temporary first names such as Babyboy or Babygirl for use on identification wristbands. But those nondistinct names can result in NICU patients having the same or similar identifiers--and increases the risk of a mix up in medical orders.

But when researchers incorporated the mother's first name into the newborn's temporary first name (e.g., Wendysgirl), they compared the rate of near misses before and after the implementation of the intervention and found it reduced near misses of wrong-patient errors by 36 percent. 

A national study conducted in 2014 by the American Academy of Pediatrics Section on Perinatal Pediatrics found that about 82 percent of the 339 responding NICUs reported using a nondistinct naming convention, "demonstrating the wide use of these hazardous naming conventions," researchers wrote.

Lead author Jason Adelman, M.D., hopes the results of the study will mean more hospitals consider implementing specific naming conventions. While the study only looked at computerized orders, he told NPR that the new naming system has the potential to lower the rates of other errors, such as a nurse mistakenly grabbing the wrong container of pumped milk out of the refrigerator.

To learn more:
- here's the study report
- read the NPR article

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