Phlebotomist's improper use of identification compromises security. (Liability and the lab).
Q We recently discovered that one of the phlebotomists in the lab has routinely borrowed one of our pathologist's lab coats and has worn it on the floor when she was drawing blood. The problem is that the lab coat is embroidered with the pathologist's name. When asked about it, the phlebotomist defended herself by saying that she only borrowed the coat because she was cold. What liability, if any, does this pose for the lab, and how should we handle the situation?A One of the most significant issues in any hospital is security and control of its staff. Patients have the right to know who is delivering their care and the right to rely on the representations of the hospital and its staff with respect to the identity and training of caregivers. By wearing a lab coat with someone else's name on it, especially if it obscured other, correct identification, the phlebotomist misled both the patient and potentially, the other staff. The hospital would be potentially liable for any damages that might flow from such a misrepresentation.
It appears no real harm was done to any patient as a result of the borrowed coat. Counseling the employee about her responsibilities and the importance of proper identification is probably sufficient. You should document the counseling as well as formulate a plan to monitor compliance to insure that no further incidents occur.
It is possible, even likely, that you have other employees who are unaware of the proper standards for maintaining proper identification. You should use this opportunity to educate the entire lab staff about the importance of proper identification, through written memorandum, in-service, or both.
Although this situation posed no real problems for patient care, the potential ramifications of misidentification can be enormous. The theft of identity through forged or stolen badges, for example, coupled with lax security measures, can lead to extremely serious problems with patient care, such as delivery of care by imposters, abduction of neonates from hospital nurseries, theft of supplies and medication, and the diversion of pathogenic biologicals from microbiology labs. Extreme cases, thankfully rare, have resulted in deaths of patients.
In such cases, if the hospital's security measures, including control of means of identification, are lax, the hospital may be found liable for civil damages. Security procedures include not only the measures taken for identification of employees, but also measures to insure that policies are followed and employees are educated about security precautions. Because you have identified a breach of security procedures, it might be a good time to review security procedures in general. Contacting the administrator responsible for security education enforcement and training, and arranging for an overall review of procedures and training may well be in order, especially in light of recently increased awareness of the need for security precautions in vulnerable public institutions.
At a minimum, a good security policy should insure that:
1) Proper identification is issued to all hospital employees upon hiring, most commonly in the form of a photo identification badge.
2) Employees are required to display their identification badges prominently at all times while working.
3) Employees are subject to discipline for failing to display identification, as well as for borrowing or lending an identification badge, or for assisting in the fraudulent alteration or duplication of hospital ID.
4) Employees are encouraged to challenge anyone attempting to perform hospital duties without visible identification, and to call security if proper identification cannot be verified according to hospital procedures.
5) Employees are required to report the loss or theft of identification badges and are required to turn in badges when terminated or suspended. The hospital should also have a procedure for alerting staff to the possible subversion of identification badges, including a method of surveillance to insure that stolen badges are not used to gain access to sensitive hospital areas.
An embroidered lab coat is a form of visible identification, as surely as an ID badge, and should be subject to the same controls. Many physicians are responsible for providing their own coats, and they should be aware of the hospital regulations regarding the security of identification devices. Although it is appealing to have a lab coat with an embroidered name, the ease with which it can be diverted, and the fact that it tends to provide instant legitimacy, means that it may be better to avoid such monogramming when possible.
Barbara Harty-Golder is a pathologist-attorney in Sarasota, FL. She directs the clinical laboratory at Health South Rehabilitation Hospital in Sarasota, as well as maintaining a law practice with a special interest in medical law. She writes and lectures extensively on healthcare law, risk management, and human resources management.
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| Author: | Harty-Golder, Barbara |
|---|---|
| Publication: | Medical Laboratory Observer |
| Article Type: | Brief Article |
| Geographic Code: | 1USA |
| Date: | Nov 1, 2001 |
| Words: | 780 |
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