Two-Identifier System
Use at least TWO patient identifiers before any procedure, medication administration, blood draw, or treatment. Acceptable: full name, date of birth, medical record number. NOT acceptable: room number, bed number, diagnosis. Ask patient to state name and DOB (open-ended questions) — do not ask "Are you Mr. Smith?" Check wristband against MAR/order. If patient unable to respond (unconscious, confused): verify with family, chart, wristband. Two RNs for blood transfusion verification.
Special Populations
Neonates/infants: use mother name + infant identifier (e.g., "Baby Boy Smith, DOB, medical record #"). Wristbands for mother and infant, linked identifiers. In emergencies: use temporary identifiers, assign permanent ASAP. Patients with same name: use additional identifiers (DOB, MRN) — never assume. Patients who cannot speak English: interpreter, family member, picture ID. Unidentified patients: assign temporary ID, use unique identifier, resolve identity ASAP. Wristband allergies prominently displayed.
Technology
Barcode medication administration (BCMA): scan wristband, medication, RN badge. Electronic health record (EHR): flags, alerts, order verification. Wireless tracking. Photo in EHR for additional verification. RFID technology. Limitations: wristband scanning does not replace active patient verification. Battery, network, scanner issues — have backup. Technology supplements, not replaces, nursing judgment. Still need verbal confirmation, allergy check, visual assessment.
Important Notes
- NEVER use room number as a patient identifier — patients move rooms and assignments change.
- Ask open-ended questions: "What is your name and date of birth?" — not "Are you Mr. Smith?" to avoid leading the patient.
Clinical Tips
- Two RNs must verify blood products before transfusion — check identity, blood type, compatibility, expiration.
- For neonates, use the mother name plus infant identifier — link wristbands to prevent misidentification.
Summary
Patient identification requires two identifiers (name, DOB, MRN — never room number), open-ended questions, and barcode technology as a supplement.
