Description

when must two patient identifiers be used ?

### When Must Two Patient Identifiers Be Used?

Ensuring the correct identification of patients is a critical component of patient safety in any healthcare setting. It’s a step meant to prevent errors and ensures the person receiving the care, medication, or test is indeed the correct one. The Joint Commission, a recognized body committed to maintaining and improving healthcare standards, has set a mandate that patient care practitioners use at least two identifiers when interacting with patients or processing specimens, medications, or test results. Here we discuss the context, practical application, and a few key considerations of when these identifiers must be used.

#### Why Two Identifiers?

Human error is a complex issue, but simple checks have proven to be effective in reducing these errors. The idea is to ensure that there are multiple points of verification used to confirm a patient’s identity. Typically, the two identifiers include the patient’s full name and date of birth although other specific identifiers can be used, such as a medical record number, if the first two are not unique enough in a healthcare setting.

#### When to Use Two Identifiers?

1. **Before Medication Administration**
Before a patient is given any medication, two patient identifiers must be confirmed to prevent administering the wrong medication to the wrong person. This includes when administering medication in the form of oral medication, injections, or topical skin applications.

2. **Diagnostic and Therapeutic Procedures**
Prior to performing any diagnostic or therapeutic procedure, it is essential to use two identifiers to ensure the procedure is performed on the correct person. This can range from collecting biological samples for test analysis to complex activities like surgical procedures.

3. **Specimen Collection and Handling**
When collecting a patient specimen, it is vital to use two identifiers to ensure the specimen being collected pertains to the correct patient. Beyond the collection, these identifiers must also be on the container storing the specimen to maintain integrity and traceability.

4. **Transferring a Patient for Care**
When a patient is being transferred from one care setting to another, whether within the same facility or between facilities, two identifiers must be confirmed at the point of transfer and during the initiation of care by the receiving team.

5. **Before Treatment Administration**
This includes any form of treatment, from chemotherapy to physical therapy. Confirming the patient’s identity using two identifiers is a key step in ensuring the treatment prescribed and administered aligns with the patient records.

#### Implementation and Challenges

While two identifiers are often used to avoid identification errors, it’s important to realize the reliance on two identifiers alone might not completely eliminate all potential errors. For example, errors in data entry or confusion due to similar-sounding names can still occur. Therefore, it’s critical to combine the use of patient identifiers with other patient safety protocols and human verification checks.

It’s also important to consider the patient’s involvement in their own identification. Engaging the patient in verifying their identity, like asking them to state their name and date of birth, can add another layer of safety. Some organizations have implemented electronic identifiers like RFID technology to enhance the reliability of patient identification.

#### Conclusion

The requirement to use two patient identifiers is a foundational element of patient safety protocols and should be rigidly followed. Doing so not only helps protect patients from harmful outcomes but also bolsters the trust and confidence that the public has in the healthcare system. Every person in a patient service role, from nurses and doctors to laboratory technicians, must be vigilant in this procedure to maintain the highest standards of care.

Understanding and following these guidelines are essential for maintaining patient safety and reducing the risk of mistakes that can happen in an often fast-paced and sometimes chaotic healthcare environment. Proper identification processes help to ensure that every step of a patient’s care journey is accurate and secure, from initial admission through every procedure or treatment to final discharge.