• PERIOPERATIVE GRAND ROUNDS Say It Again potassium supplementation, the physician glanced in individuals receiving information write down (or enter into a computer) the complete order or test result, read owner, Nurse Collaborations, Boerne, TX. (Citation: Henriksen K, Hall KK. Say It Again. AHRQ Web M&M se.aspx?caseID¼244. Accessed December 14, 2012. Millie & Bailey Preschool With Plush Pal more. ) Dr Girard has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.

[serial online]. This content is adapted from AHRQ Web M&M (Morbidity & Mortality Rounds on the Web) with permission from the Agency for Healthcare Research and Quality. The original commentary was written Kerm Henriksen, PhD, and Kendall K. Hall, MD, MS, and was adapted for this article by Nancy J. Girard, PhD, consultant/ the electronic health record to see what the patient’s previous potassium levels were. To his surprise, he found the patient did not have a potassium level listed for that day, nor had one had been ordered or drawn. The physician and the charge nurse then discovered that the panic value was intended for a different patient with a similar last name.

It was unclear whether a “read- back” had occurred between the laboratory technician and the nurse. Luckily, this was a near missdthe patient did not receive the unnecessary and potentially dan- gerous potassium supplementation and had an otherwise uneventful hospital course. Discussion: The case involves mistaken patient identity and raises concern about whether the laboratory technician and nurse were remiss in not engaging in a read-back as part of their information exchange. In 2004, as part of its National Patient Safety Goal that focuses on effective communication, The Joint Commission specified that The Case: A 72-year-old man was admitted to the hospital with pneumonia and hyponatremia. During the patient’s third night in the hospital, the charge nurse contacted the on-call physician because she had received a “critical panic value” call for a potassium level of 2.2 mmol/L (a normal level is 3.5 mmol/L to 5 mmol/L).

While writing orders for an electrocardiogram and immediate 388 j AORN Journal � March 2013 Vol 97 No 3 it back, and require the individual who gave the order or test result to confirm that the information was read back correctly.1 Read-backs help ensure that a message is understood by the receiver in the way that it was intended by the sender. In health care, read-backs have been emphasized and studied in emergency medical services,2 emergency departments,3 and surgery4-6 and for laboratory test results7,8 and patient hand offs.9 Read-backs have their greatest potential value when there is background noise or other environmental dis- tractions, when misinterpretation might result from sound-alike letters or words, when numbers or letters might be missed or reversed, or when there is ambiguity in the words used. Despite the common sense notion of using read-backs to improve communication, however, simply issuing a requirement for them is not the same thing as ensuring compliance or commitment to it. Although deceptively simple, the implementation of and adherence to read- backs can be challenging for harried health care providers.

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