by Joe Bryowsky RN, CCRN Clinical Manager
A myriad of problems could occur because a patient was not identified correctly. The most common is medication errors but that is only the tip of the iceberg, so to speak. Other detrimental results such as wrong surgeries, wrong discharge instructions, improperly taking/giving blood or blood products and other specimens for clinical testing are just a few of the others that could occur if a patient is not properly identified.
In 2004 The Joint Commission (TJC) recognized the need for proper patient identification when it issued their very first Patient Safety Goal which is referred to as the “two Identifier Rule”. There are 2 basic parts to this rule and they are:
1.) Use at least two patient identifiers when administering medications, blood, or blood components; when collecting blood samples and other specimens for clinical testing; and when providing treatments or procedures. The patient’s room number or physical location is not used as an identifier.
2.) Label containers used for blood and other specimens in the presence of the patient
Acceptable patient identifiers can vary from hospital to hospital and it’s always best to consult the hospitals policy and procedure manual for what is acceptable at a particular facility. The most common patient identifiers are:
1.) Name
2.) Date of birth
3.) Telephone number
4.) An assigned identification number
5.) Address
6.) Photograph
7.) Social Security Number (most institutions don’t use this due to the proprietary nature)
These TJC “rules” are pretty straightforward yet regrettably not always followed, or are followed improperly. When confirming two patient identifiers with patients, it’s not enough to provide the information and have the patient confirm (the patient may be confused, hard of hearing, etc. and the patient may just confirm what you’re telling them whether right or wrong). You must ask the patient to identify themselves/provide the patient identifiers. When identifying a patient remember that the number one rule is to ask only open-ended questions. Examples of this are:
A.) Would you please state your name?
B.) Would you please state your date of birth?
C.) How are you feeling today?
If the patient is not alert and oriented, or is deaf, the patient arm band can usually be used for identification but one needs to proceed with caution with this. There have been documented cases where the name band has been either put on the wrong patient, or the wrong patient was input by admissions.