Babyboy/Babygirl: A National Survey on the Use of Temporary, Nondistinct Naming Conventions for Newborns in Neonatal Intensive Care Units

Risk of Wrong-Patient Orders Among Multiple vs Singleton Births in the Neonatal Intensive Care Units of 2 Integrated Health Care Systems

“…3,9 A national survey conducted in 2013 noted that 82% of NICUs reported using nondistinct naming conventions for newborns, and only 15% of NICUs changed temporary names to given names during hospitalization based on concerns about the lack of systems interoperability. 10 The use of a distinct newborn naming convention that incorporates the mother's first name (eg, Wendysboy or Wendysgirl) has been associated with a 36% reduction in wrongpatient orders in the NICU compared with a nondistinct naming convention. 9 Based on this finding, as of January 2019, The Joint Commission requires all hospitals to use distinct methods of newborn identification, such as naming conventions that incorporate the mother's first name, as part of its National Patient Safety Goals (Box).…”

“…11 However, the distinct naming convention examined in previous studies 3,9 may not be as effective for multiple-birth infants as for singletons because siblings of multiple births have the same last name and nearly identical first names (eg, Wendysboy1 and Wendysboy2). 7,9,10,12 Furthermore, in a national NICU survey, 20% of respondents reported that long names were visually truncated in the electronic health record, potentially removing the distinctive last character from the first names of multiple-birth infants and resulting in identical-looking names. 10 Although the use of distinct naming conventions has been associated with reductions in the risk of wrong-patient order errors in NICUs, it is unclear if multiple-birth infants remain at increased risk.…”

A National Survey on the Use of Temporary Naming Conventions for Newborns: 5-Year Follow-up

“…10 A national survey conducted through the American Academy of Pediatrics in 2013 found that only ~20% of NICUs in the United States used a distinct naming convention. 11 The extent to which hospitals adopted this safety practice after The Joint Commission recommendation is unknown.…”

Effect of an Alternative Newborn Naming Strategy on Wrong-Patient Errors: A Quasi-Experimental Study

“…sequentially, identical surnames for multiple patients, and multiple births (e.g., twins or triplets) with nearly identical names and MRNs. [3][4][5]9 Strategies to prevent patient misidentification involve double checking of identifiers by clinicians such as MRN and date of birth. However, for newborns' with the same date of birth, sequentially assigned MRNs may be identical except for a single digit.…”

“…Based on a national survey in the U.S. hospitals, Adelman and colleagues reported that nearly 82% of NICUs in the United States used a nondistinct naming strategy for temporary newborn names. 9 Extending from this survey, they proposed and evaluated a distinct naming strategy for temporary newborn names. The distinct naming strategy had the following format: mother's first name, a possessive "s," newborn's gender and the mother's last name (e.g., the newborn of "Jane Doe" would be recorded as "Janesgirl Doe").…”