Patient ID

[BANKTECH]

We currently use patient name and medical record number to identify the patient. We are considering using a special blood bank identifier (typenex, hollister). My question is, if in the middle of an admission the patient name changes, is the medical record number and other blood bank ID system acceptable for 2 identifiers. THE NAME WILL BE INCORRECT.

Please advise.

[SMILLER]

I am guessing that your facility, like every other in the US, uses the patient's name as one of the two identifiers that must go on anything having to do with a patient.  If the name changes, you no longer have that link between the specimen drawn (and the armband) and your BB records (which produce the crossmatch tags that must match the patient's armband).  So the patient would have to be redrawn with a new armband and the new name.

 

At least, that's how we do it.

 

Scott

[David Saikin]

We use the birthdate and mr# as identifiers.  We also use bloodloc codes for every admission.  The BL code is to affirm the specimen came from the pt wearing the code.  In an emergency we can transfuse on the BL code alone (esp if there is no other identifying info).  The code can only be interpreted at the bedside at the time of transfusion and the only place it exists is on the pt's BL band (put on by admitting) and the tube used for pre-transfusion testing. 

[Barb Thompson]

If the name on the BBID band doesn't match the name on the hospital band, we redraw the patient.  This happens more than we would like.  Sometimes a misspelled name gets corrected (redraw), sometimes the last name gets changed (redraw) and sometimes both first and last names are changed (redraw).  The only time we are ok with changes is when the first and last names are swapped (Mary,Smith becomes Smith,Mary).  This is a rather sticky situation.  We are not a trauma center and do not get Jane or John Doe patients, but I imagine those that do have a different set of policies. Patient name is our #1 identifier, so the name has to match.

[BANKTECH]

Do any of your facilites require ID before admission (except trauma). I'm wondering if government issued ID and insurance cards upon admission would help with this problem. This person was admitted with one name and then the name was changed. No one was identified of the change. Same armband remained on the patient. Computer information did not match. The resolution that is being considered are the blood band. Although it would have 2 unique identifiers, the patient is still ID'd incorrectly. A redraw would still be required, correct?

[tbostock]

 

Do any of your facilites require ID before admission (except trauma). I'm wondering if government issued ID and insurance cards upon admission would help with this problem. This person was admitted with one name and then the name was changed. No one was identified of the change. Same armband remained on the patient. Computer information did not match. The resolution that is being considered are the blood band. Although it would have 2 unique identifiers, the patient is still ID'd incorrectly. A redraw would still be required, correct?

Our policy requires that the patient present a driver's license or other legal form of ID. But our registrars have told us that some patients refuse. Odd that we would allow that when there is so much insurance fraud going around.

[Deny Morlino]

ID required at point of admission here as well.

[rravkin@aol.com]

ID required at point of admission here as well.

What do you do about an unresponsive patient brought to the ED by Emergency Responder with no ID and accompanied by no one and requiring blood products?

[Deny Morlino]

We use a blood band ID system. Patient identified as John or Jan Doe and cross match performed.  Band remains on patient until ID is corrected.  As soon as there is a period of time allowing redraw and reband for blood bank, that is completed as well as repeat of blood bank testing with a new specimen with correct ID.  The BB band is the source of truth in an unknown ID situation for blood bank and ED until identity can be properly established.

[SMILLER]

Same here.

Scott

[AMcCord]

Trauma patients - same as Deny and Scott.

[KKidd]

Our biggest problem is with L&D. A patient will come in who has pre-registered under her maiden name. As soon as we have completed the type and screen, she informs her nurse that her last name has changed. We require a new draw. The patient now has a new hospital armband and future orders will contain the new name. I would hate to set anyone up for an ID error.

[pbaker]

Just because they present with a valid ID, does not mean that registration will type the name correctly!!

[Mabel Adams]

Regulations require either 2 unique identifiers (TJC although they accept DOB which isn't unique) or 2 independent identifiers (AABB). Anything you use beyond that is according to your own risk assessment. We accept presence or absence of middle initials but not a change to a different one.  All other name problems get redrawn although we deal with a name change from our trauma system until we can reasonably get a new specimen drawn.  If you get a BB band system, you have to manage another place for identifiers to be wrong. It won't fix underlying ID problems in your system on its own.

[John C. Staley]

Just because they present with a valid ID, does not mean that registration will type the name correctly!!

 

Or that it is THEIR valid ID.  We see a fair amount of card sharing and if the admission folks don't look close they never notice.  Humans have a nasty habit of seeing what they expect. 

[SMILLER]

We have indeed had a few cases where a patient will turn out not to be who their ID says they are. These are people with no insurance and borrow a friend or relative's ID.

One of the only ways to catch these is if there is a previous BB history, we do a ABO/Rh on the imposter, and the blood types do not match.

Scott