Managing Patient Identification: The Right Patient, Every Time

In any unit, one of the most important safety checks is making sure the right patient receives the right treatment. The Joint Commission knows the importance of identifying each patient before tests are run, medications administered or procedures performed. Last week, The Joint Commission released the new National Patient Safety Goals for 2009, and the first goal on the list is: “Improve the accuracy of patient identification.” Being able to locate the proper identification in a timely fashion to guarantee patient safety is absolutely critical in medical error prevention.

Every step in the patient experience from identification, assessment, testing and diagnosis should be accompanied by identification verification with two patient identifiers. These need to be unique and not related to patient location. Examples are the patient’s name and birth date.

One of the biggest concerns in patient identification procedures is how to incorporate these patient identifiers into electronic medical records. When the records are formatted, it's important to consider the needs for identification and how that information is recorded for future access. For example, one hospital chose to use each patient’s name and medical record number as forms of identification. The education process was thorough for both the nursing and medical staff members. However, when dictations from the physicians were filed, medical record numbers and patient visit numbers were confused. This caused delays and frustration to multiple members of the care team. The issue had to be resolved by stating the medical record and visit numbers, in addition to the patient name, during dictations.

The new addition to this goal for 2009 is: “Eliminate transfusion errors related to patient misidentification.” Blood components must be confirmed with two patient identifiers. Many electronic records now have a component to verify proper blood administration. These software applications provide safety checks cross-referenced with the blood bank records in real-time, prior to the actual administration of the unit of blood. Bar codes are assigned to the unit and crossed with the patient’s blood sample. Each of these steps serves to place another layer in the patient safety process. When an automated identification technology is not available, two qualified individuals must verify the blood products prior to administration.

Checking for patient identification can sometimes frighten the patient. Already fearful from having to seek medical care, it’s important to offer reassurance that by checking their identification, you are looking out for their safety. This can be done by verbalizing intent. For example, “Mrs. Jones, I am checking your armband for your safety.” This simple statement, verifying an action that is done multiple times a day, communicates that she is being properly cared for.

For more information, visit The Joint Commission Web site.

This discussion on the first National Patient Safety Goal for 2009 is the third in our series. If you have examples of clinical situations that demonstrated the importance of this or any other goal, please share it by e-mail with Lorrobertson@yahoo.com.