Standardising wristbands improves patient safety: guidance on

implementing the Safer Practice Notice (SPN 24, July 2007)

and the related information standard on core patient identifiers approved by the Information Standards Board for Health

and Social Care in March 2009

Author: Dr Beverley Norris (updated by Chris Ranger)

Date: 19 April 2009

Doc Ref: 1.8

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Contents

Background1. Why is it important to standardise wristbands? 2. Why do we need a second NPSA Safer Practice Notice on wristbands? 3. Have staff and patients been consulted about standardising wristbands

and the NPSA’s recommendations? 4. Are patients allowed to wear their own wristbands, for example to denote

‘no blood products’? 5. What is the procedure if the organisation does not feel it can comply with

the Safer Practice Notice or elements of the Notice?The design of wristbands6. What kind of wristbands should we use?7. Where do I get a wristband that meets the NPSA design guidance? 8. Does the NPSA recommend the use of technologies such as barcoding

and radio frequency identification (RFID) on wristbands? Patient identifiers9. Are the core patient identifiers for wristbands mandatory? 10. Do the patient identifiers also apply to newborns? 11. Why isn’t gender one of the core patient identifiers for wristbands? 12. The NHS Number isn’t available on most of our patient records, how do

we check notes against the wristband? 13. Is there a standard layout and format for the identifiers on a patient

wristband?14. Where should any additional identifiers (including hospital number) be

located?15. What should I do if one or more of the four identifiers is missing?16. Why is it a requirement of the Safer Practice Notice for Welsh

Organisations to include first line of address as a core identifier on a patient’s wristband?

17. Why is it recommended that wristbands are white with black text – we’ve always used yellow bands because they show up well?

Processes for producing, applying and checking wristbands18. Is there NPSA guidance on processes for issuing, checking and changing

wristbands? 19. Where should the patient and member of staff sign to say the information

on the wristband is correct, or that the wristband has been changed for a specified reason?

The use of coloured wristbands 20. Why is the NPSA concerned about colour coding wristbands? 21. Our Trust currently uses red wristbands to identify if a patient has an

allergy. The system has been in place for over 10 years and is recognised practice, so why should we stop it?

22. How will staff who move jobs know if their new healthcare organisation is using a system of a red wristband for known risks?

23. What patient risks should I use red wristbands for? 24. We currently use green wristbands for patients at risk of falls, how do we

protect these patients now? 25. What about food and nut allergic patients?26. We need to know when patients are radioactive, so why can’t we use a

coloured wristband?Appendix 1: Algorithm for the safe identification of unknown, unconscious or incapacitated patients – on the same NPSA webpage as this guidance

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Appendix 2: Algorithm for the safe identification of newborns - on the same NPSA webpage as this guidance

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BackgroundThis document was developed originally to help NHS organisations implement the NPSA Safer Practice Notice (SPN) 24 ‘Standardising wristbands improves patient safety’. Further work has been done by the NPSA to develop the related information standard on core patient identifiers approved by the Information Standards Board for Health and Social Care, for which NHS Connecting for Health (NHS CFH) is the sponsor and longer-term developer. A key output is the development of supplementary organisational and behavioural guidance to support full implementation of the core identifiers in the NHS. Implementation of the Patient Identifiers for Identity Bands standard is dependent on implementation of the related NHS Number Standards – DSC Notices 31&32/2008. This guidance should be read in conjunction with NHS Number Implementation Guidance available at the NHS Number Programme website - http://www.connectingforhealth.nhs.uk/systemsandservices/nhsnumber . Both sets of guidance are consistent.

1. Why is it important to standardise wristbands? Between February 2006 and January 2007, the NPSA received 24,382 reports of patients being mismatched with their care. More than 2,900 of these related to wristbands and their use. Standardising the design of patient wristbands, the information on them, and the processes used to produce and check them will improve patient safety. There is increasing evidence to show that standardising elements of patient care, such as these, contributes positively to patient safety1. Also, wherever staff work in the NHS in England and Wales, they will know what to expect on wristbands as patient identifiers.

2. Why do we need a second NPSA Safer Practice Notice on wristbands? This notice builds on the NPSA’s Safer Practice Notice, Wristbands for hospital inpatients improves safety (November 2005), which was about ensuring that inpatients wear wristbands and that they are accurate. The current Notice recommends action aimed at standardising wristbands. This will help to further improve patient identification and ensure patients are matched with the care intended for them. Both notices are part of a wider programme of NPSA work on safer patient identification and matching patients correctly to samples, specimens, records and treatment. Related work can be found at http://www.npsa.nhs.uk/patientsafety/alerts-and-directives/directives-guidance/patient-identification/

3. Have staff and patients been consulted about standardising wristbands and the NPSA’s recommendations? The views of patients have been obtained through special workshops. Staff and their professional organisations have been consulted through workshops and a survey. They were also asked to comment on the original proposal for the work and the draft Safer Practice Notice. A full report of the consultations is on the NPSA website at www.npsa.nhs.uk/alerts 2

4. Are patients allowed to wear their own wristbands, for example to denote ‘no blood products’? Patients who wish to wear their own wristbands in hospital should be permitted to do so, but advised of the dangers of confusion for staff.

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5. What is the procedure if the organisation does not feel it can comply with the Safer Practice Notice or elements of the Notice?The Safer Practice Notice represents the view of the National Patient Safety Agency, which was arrived at after consideration of the evidence available. It is anticipated that healthcare staff will take it into account when designing services and delivering patient care. This does not, however, override the responsibility of individual healthcare staff to make decisions appropriate to local circumstances and the needs of patients and to take appropriate professional advice where necessary. If an organisation decides not to implement this guidance it should undertake a full risk assessment of the proposed alternative and be assured that the alternative is at least as safe.

The design of wristbands6. What kind of wristbands should we use?Consultation with users and with manufacturers has identified a need to improve wristband comfort, durability and ease of use. The following recommendations have been developed which should be considered in selecting a wristband (the design guidance can be found at www.npsa.nhs.uk/alerts):

Size3 Wristbands must fit the range of sizes of patients, from the smallest newborn babies through to the largest adults. Wristbands should therefore be: Long enough to accommodate bariatric patients, patients with oedema (swelling)

and patients with IV lines and bandages Small enough to be comfortable and secure for newborns, babies and children.

Comfort4 Shape - There should be no sharp corners, profiling or edges that can irritate or

rub the skin. Edges – The edges of wristband material must be soft and smooth to ensure

comfort over prolonged use. This includes any edges that are produced when cutting the wristband to size.

Fastenings – Fastenings should not press into the skin. Material – Wristband material should be flexible, smooth, waterproof, cleanable,

breathable and non-allergenic5

UsabilityWristbands should be: Easy to clean Waterproof and resistant to other fluids (soap, detergents, gels, sprays, rubs,

alcohol cleaning products, blood and other bodily fluids) Secure and not fall off Designed to allow patients to wash Quick and easy for all staff to use 6. This includes:

Storage Access from storage Filling in patient identifiers Changing or updating information Reading and checking information Putting on patients (including selecting the correct size or adjusting to correct

length) Fastening

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Removal The wristband should not catch on clothing, equipment or devices including IV

lines. Special attention should be paid to fastenings and free ends. The NPSA recommends that patients wear one wristband only. If there is a

circumstance where it is essential to use more than one wristband, all the bands should satisfy all of the above requirements.

7. Where do I get a wristband that meets the NPSA design guidance? Ask your current supplier to explain how their products meet the design requirements.

The NHS Supply Chain will be including these requirements in their contracts.

Designing and testing wristbands must account for the range of users (patients and staff) and the range of working conditions and clinical conditions under which wristbands will be used.

Users:a. Smaller wristbands (width and length) are needed for neonates,

babies and children so that they are comfortable and secure. b. Patients will have clinical conditions which will affect how wristbands fit

and how comfortable they are, and these may change during their stay. Interventions and treatments will be carried out which may be difficult with the wristband in place. All of these factors will contribute to the likelihood of the wristband being removed and should be considered in the design of wristbands.

c. Wristbands are worn continuously, including during sleep, and over prolonged time periods. Materials, shapes and edges that feel soft on initial touch may therefore prove uncomfortable over prolonged use. Assessment of wristband designs must be based on how they will feel to the most vulnerable users and over prolonged use.

d. Wristbands are issued by all staff including all levels of nursing staff, Health Care Assistants and administration staff. Therefore training will not be available for all staff and the use of wristbands should be intuitive, including where and how to fill in patient identifiers, checking of information, fastening and removal.

e. Representatives of the whole range of users should be consulted during the design and testing of wristbands. If access to users is limited ensure that the sample includes representatives of the most at-risk users (both patients and staff).

Working and clinical conditions:Testing should be contextual and representative. This means that the range of working environments, length of stay, clinical specialties and treatments should be represented in the testing. Think about how the wristband would be used in high risk situations such as low-lighting, staff shortages, shortage of supplies, patient with multiple interventions etc.

8. Does the NPSA recommend the use of technologies such as barcoding and radio frequency identification (RFID) on wristbands? Ensuring all patients have a wristband in a standard format means they can be used, to carry a barcode, for example of the patient’s NHS Number, and to verify the patient’s identity at any stage of their care or treatment, even if they are transferred to another hospital. The development of technologies including barcoding, radio frequency identification (RFID) and biometrics (for example, fingerprints and iris scanning) is improving patient identification and the matching of patients to their care. The Department of Health has issued a guidance paper on the use of simple technology for safer patient care, with examples of the use of barcoding and RFID to

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promote safer patient identification7. Wristbands should therefore allow the incorporation of new technologies that may be used to assist patient identification e.g. RFID tags or barcode technologies, whilst still fulfilling the other requirements.

Patient identifiers 9. Are the core patient identifiers for wristbands mandatory?

The NPSA recommends that Trusts should use the specified core patient identifiers on wristbands (i.e. LAST NAME, first name, date of birth and verified NHS Number). If any additional identifiers are thought to be necessary, these should be formally risk assessed in relation to the safe use of the four core identifiers. The related information standards on patient identifiers for identity bands, specifies the four identifiers that must be included on NHS patient identity bands and the format for presenting these so that identity information is clear and unambiguous. All suppliers of healthcare systems which produce identity bands for use in the NHS are required to comply with the standard. . Each patient identifier is consistent with the Common User Interface (CUI) Design Guide as will be required by NHS Connecting for Health through their Common User Interface (CUI) work which is part of the introduction of the National Programme for IT in the NHS9. In addition the ordering of the fields is consistent with the current CUI screen design.

10. Do the patient identifiers also apply to newborns? For newborns, in addition to the NHS Number, the identifiers should include baby boy/girl (mother’s last name) to ensure that the baby can be matched to the mother when in hospital, and date and time of birth. Where the NHS Number is not available, a temporary number should be used, for example, the hospital, casenote or A&E number. Further information about the process to be used for identifying newborns, is available on same webpage as this guidance. www.npsa.nhs.uk/alerts

11. Why isn’t gender one of the core patient identifiers for wristbands? We know that gender is not widely used in the NHS as an identifier and that it is not favoured by NHS staff for inclusion as much as the identifiers we recommend. Also, there is no evidence that including gender is safer than not including it as a core identifier. Audits of blood sample labelling both internationally and in England showed that gender was a poorly used identifier10. Other evidence comes from a survey of NHS staff carried out by the NPSA in 2006 which found that gender was seventh in a list of most used identifiers (behind ‘ward’ and ‘hospital consultant’) and that NHS staff rated the usefulness of gender as an identifier as low (see reference 2 below). The SPN says that if any additional identifiers are thought to be necessary, these should be formally risk assessed in relation to the safe use of the four core identifiers. A formal assessment within Trusts could conclude that it is appropriate to use gender when other information is lacking, for example for unconscious and/or unidentified patients.

12. The NHS Number is not available on most of our patient records, how do we check notes against the wristband?

The NHS Number is not consistently used as a the unique national identifier for NHS patients currently, but all the evidence suggests when it is used in combination with Last name, First name and Date of Birth it will enable safer patient identification. Nationally NHS Number availability varies between about 70% and 98%, so the verified NHS Number should be available for use for most patients. The availability of NHS Numbers will vary across the country, depending on the quality of demographic data collection at Trusts, which impacts on the ability to trace the Number, and the system of automatic matching and clearance of non matches. Initial primary care

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data collection is important as poor data collection can impact on match rates. Some areas of the country are taking the initiative to improve NHS Number coverage and also their data collection processes through effective data quality improvement programmes within the NHS. Availability of the NHS Number is compounded by the catchment area of the Trust and the percentage of patients who are overseas visitors, immigrants, or asylum seekers, who are less likely to have a NHS Number or for it to be easily available. If the verified NHS Number is not immediately available, a local hospital number should be used until it is and the NHS Number space on the band left blank.

13. Is there a standard layout and format for the identifiers on a patient wristband?Standardising the layout and format of these identifiers will increase legibility and clarity. The following requirements relate to the layout of information on a wristband: The space available for patient data should be adequate for the patient identifiers

to be recorded clearly and unambiguously. The same layout, order of information and information style should be used on all

wristbands across the organisation to encourage standardisation. This helps make wristbands easier to read and avoid errors.

Pre-defined spaces for each identifier or a pre-printed format can help encourage standardization e.g. consider using a title or box for each identifier (see figure 1), but without reducing the space available for the patient identifiers.

The related information standard on patient identifiers for identity bands, specifies some aspects of format and layout that must be used and these are included in the text below which follows figure 1, and defined by use of the word ‘must’.

14. Where should any additional identifiers (including hospital number) be located?The NPSA says in the SPN (24) on standardising wristbands, that only the four core patient identifiers should be used on wristbands. However, there may be circumstances where it is thought necessary to have one or more additional identifiers on the band. If any additional identifiers are thought to be necessary, they must be formally risk assessed in terms of why they are necessary, how they are distinguishable from the four specified identifiers and how they are located on the identity band so that the four identifiers remain clear and unambiguous. They should not be placed where they could be confused with any missing core identifiers. The NHS Number space on an identity band should only be used for a verified NHS Number. If the verified NHS Number is not available, this field should be left blank. If a hospital or local number has to be used, it is best to label it as such.

15. What should I do if one or more of the four core identifiers is missing?If one or more of the four core identifiers is missing, it may be necessary to use another or other identifiers depending on the circumstances. If the missing identifier is the verified NHS Number, please see the advice for 14 above. If the identifiers are missing because the patient is unknown, incapacitated please see the algorithm in appendix 1. This shows that if an unknown, incapacitated or unconscious person is admitted, the wristband should show the following information:

Unknown Male/FemaleOrUnknown Male/Female Child

Temporary Local number

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In this case, the suggested layouts at 1a and 1b would not be appropriate and a wristband without predefined spaces should be used. Once complete information is known about the patient, the original wristband should be replaced with a wristband that contains all four core identifiers and this should be recorded in the patient’s notes.

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Figure 1: Suggested layouts for patient identifiers1a

Last Name

First Name

Date of Birth

NHS Number

1b

Last Name

First Name

Date of Birth

NHS Number

1c

If pre-defined spaces are not used, pre-printed lines can be used to help make information easy to read. This is particularly useful for write-on wristbands.

The suggested layout shown in figure 1 shows the patient’s name on one line, in the order LAST NAME, First name. If it is not possible to display the names on one line, a compromise would be to add the titles (as shown in figures 1a and 1b), to help differentiate last and first names, which otherwise would only be indicated by the use of upper case for last name.

Date of birth must be recorded in the short format, in the style recommended by the NHS Connecting for Health Common User Interface Design Guide9 as follows:

DD-Mmm-YYYY e.g. 07-Jun-2005Where DD is the two-digit dayMmm is the abbreviated month name (e.g. Feb)YYYY is the four-digit year

Day values less than 10 must appear with a zero in the first position e.g. 08Month names must be abbreviated to the first three lettersDay, month and year separators must be hyphens

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Priority should be given to the patient name in that they are displayed above the other identifiers.

First and last name must be clearly differentiated by using lower case letters for first name (with upper case first letter) and UPPER CASE for last name, and must be presented in the order: LAST NAME, First name9 e.g.

SMITH, John

There should be enough space to include long names, multiple names and hyphenated.

Identifiers should be in a font size and style that is easy to read. Avoid italic, simulated handwriting and ornate typefaces9. Use a common sans-serif typeface like Arial, Helvetica or Frutiger Roman 11, 13. Use a minimum font size of between 12 and 14 point (equivalent to a height of 2-2.3mm) 11, 12, 13.

Black text on a white background should be used to ensure the wristband is clearly legible in reduced lighting conditions (such as wards at night) and by those with visual impairments 11, 12.

The NHS Number consists of 10 digits – the first nine digits constitute the identifier and the tenth is a check digit that ensures its validity. The format for display of the NHS Number must be 3 3 4, because this format aids accurate reading and reduces the risk of transposing digits when information is taken from a screen14.

16. Why is it a requirement of the Safer Practice Notice for Welsh Organisations to include first line of address as a core identifier on a patient’s wristband?The use of the first line of address is a requirement of Welsh Health Circular (2007) 042 Blood Transfusion, issued by the Welsh Assembly Government.

17. Why is it recommended that wristbands are white with black text – we’ve always used yellow bands because they show up well? Black text on a white background is recommended as this provides the best contrast, which is a vital factor in legibility (recommended by both the Royal National Institute for the Blind and EuroBlind's guidance on accessible information). The NHS Toolkit for Producing Patient Information recommends 'dark print on light background'.

Processes for producing, applying and checking wristbands

18. Is there NPSA guidance on processes for issuing, checking and changing wristbands? The NPSA gives the following guidance: Any member of staff who issues and checks wristbands should be trained and work to clear and consistent processes that are defined in trust protocols. These protocols should include processes for:

applying wristbands where patients are unable to supply the necessary identification information;

ensuring the legibility of handwritten wristbands (until all wristbands can be printed);

the member of staff applying the wristband and the patient receiving it to sign the patient record (or a relative or carer where the patient is unable to do so) to verify that the details are correct;

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re-applying wristbands that have been removed for clinical procedures, taken off for some other purpose, or have fallen off;

updating the information on wristbands and re-applying if there is a need to amend any of the identifiers, such as when an NHS Number is verified and the band reprinted with updated information.

establishing correct patient identification prior to any treatment or care and at handover, such as by asking the patient (where possible) to state their first name, last name and date of birth, and checking these details against the wristband and the clinical records.

19. Where should the patient and member of staff sign to say the information on the wristband is correct, or that the wristband has been changed for a specified reason? The NPSA recommends that casenotes are the most logical place for the member of staff and the patient to sign that the information on the wristband is correct, or that the band has been changed for a reason that should be specified such as when an NHS Number is verified and the band reprinted with updated information. This is because casenotes (either temporary or permanent) are available at the point of admission to the hospital, and are usually kept with a patient as they move through different services.

The use of coloured wristbands 20. Why is the NPSA concerned about colour coding wristbands?

From the work that the NPSA has carried out on standardising wristbands it is clear that there is inconsistent use of wristband colours throughout the NHS. This is confusing and a risk to patient safety. Evidence from literature suggests that there are a number of problems with colour-coded wristbands and little evidence to support the effectiveness of their use. In one study where red wristbands were used to indicate patients at risk of falls, this did not contribute to a reduction in falls, as anticipated. Other research has shown that there are problems about the accuracy of information provided by patients about allergies and other risks, which is the basis for giving a patient a colour coded wristband. Sometimes the information that is given by patients on admission is not reviewed or checked further by staff so that the appropriateness or otherwise of a coloured wristband can be reviewed. Also, even where patients do give accurate information about allergies and other risks, there is evidence that this does not always trigger the issue of a coloured wristband. See www.npsa.nhs.uk/alerts for more information on this and related questions below.

21. Our trust currently uses red wristbands to identify if a patient has an allergy. The system has been in place for over 10 years and is recognised practice, so why should we stop it? The NPSA believes that it is safest only to use a white wristband with black text (and only one wristband per patient) so that there is no colour coding. However, the response to our consultation about the draft Safer Practice Notice showed that a significant proportion of respondents favoured the use of one colour to represent particular patient risks. In response to that, the Notice provides for those who want a colour coding system to identify a known risk to use a red wristband for patients, with a white panel which will display patient identifiers in black text (see also question 15). This would be used instead of the white wristband, as only one wristband should be worn.

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22. How will staff who move jobs know if their new healthcare organisation is using a system of a red wristband for known risks? New staff inductions should include providing information about whether patient wristbands should be white only, or whether the healthcare organisation is using a red wristband where there is a known risk. There should still be only one wristband per patient – i.e. the red wristband is not an additional band but includes the patient identifiers. Staff moving between organisations should always ensure they are aware of the organisation’s policies on wristbands before they provide care to patients.

23. What patient risks should I use red wristbands for? The NPSA believes that it is safest only to use a white wristband with black text (and only one wristband per patient) so that there is no colour coding. If a healthcare organisation wants to use colour coding, the NPSA recommends only one colour, which is red, to be used for identifying a known risk. The type of risk will need to be established from the patient record. Where a red wristband is used to indicate a known patient risk no other wristband will be used, so this should allow the patient identifiers to be presented in black text on a white panel on the wristband. If labels are used these must comply with requirement that they are durable for throughout the patient’s stay.

24. We currently use green wristbands for patients at risk of falls, how do we protect these patients now? Please see the previous questions and answers about colour coding and why the NPSA believes it is safest only to use a white wristband with black text, but is providing for those who want a colour coding system to identify a known risk to use a red wristband for patients, with a white panel which will display patient identifiers in black text. For guidance on reducing falls by hospital patients, please see Slips, trips and falls in hospital, February 2007 (pdf) at www.npsa.nhs.uk/alerts

25. What about food and nut allergic patients? The SPN recommends that any known risk, and that includes an allergy, is identified by the use of red on a wristband – so the advice is as above. The exact risk should then be identified in the patient notes.

26. We need to know when patients are radioactive, so why can’t we use a coloured wristband?Some Medical Physics Department staff have been using either a yellow wristband or a yellow and black wristband insert to show when patients are radioactive as this provides vital information to staff while the patient is in transit and on arrival at their destination, as there may be situations where the patient record is not available.  This is important, for example, in ultrasound departments where a radioactive patient may be inadvertently placed next to patients awaiting foetal ultrasound scans.  The NPSA acknowledges that it is important that hospitals and their staff are able to identify patients easily and reliably where they have been administered radioactive substances, but this does not make the argument for the use of another coloured wristband to do so.   

Other queries

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If you have queries about the Safer Practice Notice which are not answered in this guidance or in the separate Design Guidance (www.npsa.nhs.uk/alerts) please send them to spn@npsa.nhs.uk

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References and notes

1. Rozich JD et al. Standardization as a mechanism to improve safety in health care. Mayo Health System, Eau Claire, Wisconsin, USA. 2006; Vincent CA. Patient Safety, 2006; Bates DW. Using information technology to reduce rates of medication errors in hospitals. BMJ, 320; 788-791; Berwick DM. Taking action to improve safety: how to increase the odds of success. Rancho Mirage, California 1998.

2. National Patient Safety Agency. Design and specification of patient wristbands: Evidence from existing literature, NPSA-facilitated workshops, and a NHS Trusts survey. Available at: www.npsa.nhs.uk

3. NPSA consultations with staff and patients identified concerns about the ‘fit’ of wristbands, that they can be either too tight or too loose. Accommodating the range of patients could be achieved by:

Increase the maximum length available (current maximum appears to be 250-300mm). However, if excess length has to be cut from the wristband staff should be able to do this safely, preferably without the use of scissors. Cut ends should not be sharp.

Make wristbands available in a variety of sizes 4. Patients complain about wristbands being scratchy, itchy, sweaty and hot and

this can contribute to wristbands being removed. In particular, wristbands can cause skin damage to newborn babies and to people with delicate or vulnerable skin.

5. Patients are concerned that wristbands may be a potential source of infection and should be easy to clean.

6. All staff, from nurses to administration staff and with a range of training and experience, will issue wristbands and the wristband should be easy to use by all staff.

7. Department of Health. Coding for success: simple technology for safer patient care. February 2007.

8. Information on the Information Standards Board is available at www.isb.nhs.uk

9. NHS Common User Interface (CUI) Clinical Applications and Patient Safety (CAPS) Programme. www.cui.nhs.uk

Patient Name Input and Display, Friday, 29 February 2008, Version 1.0.0.0 BaselineDesign Guide Entry – Date Display, Tuesday, 22 January 2008, Version 3.0.0.0 Baseline

10. Current performance of patient sample collection in the UK :Transfusion Medicine 2004 : M. Murphy et al.

11. The Royal National Institute for the Blind guide ‘Clear print guidelines’ http://www.rnib.org.uk/xpedio/groups/public/documents/publicwebsite/public_printdesign.hcsp

12. Making your information accessible for customers with sight problems. European Blind Union, 58, Avenue Bosquet, 75007 Paris France www.euroblind.org

13. NHS toolkit for producing patient information. 2003 Department of Health 33952 3AP NOV03 (MUL)

14. NHS Common User Interface (CUI) Clinical Applications and Patient Safety (CAPS) Programme. www.cui.nhs.ukNHS Number Input and Display, Monday, 17 March 2008, Version 2.0.0.0 Baseline

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Document Control

Change Record

Date Author Version Reason for Change

31st July 2008. Beverley Norris, NPSA 1.4 Algorithms added10th Dec 2008 Chris Ranger, NPSA and NHS

CFH 1.5 Extended FAQs at ISB

request27th Jan 2009 Chris Ranger, NPSA and NHS

CFH1.6 Dec 08 ISB Board

output compliance

23rd March 2009-

Chris Ranger, NPSA and NHS CFH

1.7 Final assessor comments reviewed and changes made

19th April 2009 Chris Ranger, NPSA and NHS CFH

1.8 Updating references and final check for accuracy

Who Has Reviewed This Document

Name Position

Chris Ranger NPSA and NHS CFHSusan Bothwell NPSA and North West SHA Julie Parry NPSAWendy Martin NPSAAnita Dougall NPSAAndrew Trew NPSA

Distribution

Name Position

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Yes – Full information ascertainable

Examples:Companion/Carer knows full detailsYoung child pt. knows full details