Client Identification, Latex Allergy and Near-Miss Reporting

Safe Client Identification Protocols

Ensuring correct client identity is a fundamental safety responsibility of the practical nurse. The practical nurse must use at least two acceptable client identifiers before administering medications, collecting laboratory specimens, or performing treatments within their scope of practice. Acceptable identifiers include the client's full legal name, date of birth, and assigned medical record number. The practical nurse must never use the client's room number, bed number, or physical location as an identifier, as physical placements can change and do not establish unique personal identity.

When confirming identity with an alert client, the practical nurse asks the client to state their full legal name and date of birth rather than asking yes-or-no questions such as 'Are you Mr. Smith?' The practical nurse then verifies the client's stated identifiers directly against the client's identification band and the medical record or prescription. When caring for a client who cannot state their identifiers, the practical nurse matches the identification band to the medical record or order and adheres to facility policy for any additional verification steps. Relying on a family member's statement alone is not sufficient to confirm identity.

Technological tools such as bar-code scanning serve as valuable electronic verification tools during care; however, bar-code scanning does not replace visual inspection of the client identification band. If an identification band is lost or damaged, the practical nurse must report the issue to the registered nurse (RN) and follow facility policy to verify identity and replace the band before nonemergency care continues. When clients on the same nursing unit have the same or similar names, the practical nurse adheres to facility procedures for name alerts and exercises meticulous care to verify two identifiers before every intervention.

Special populations require distinct verification measures. For newborn care, the practical nurse verifies two newborn-specific identifiers on the infant's band against the order or record and compares the infant's and authorized adult's matching bands when required by facility policy. When permitted by state law and facility policy, the practical nurse also participates with an authorized clinician in the required pretransfusion verification of client identifiers and blood product information. Furthermore, the practical nurse reinforces client and family education to speak up and alert healthcare staff whenever an identification check is omitted or when any aspect of care seems incorrect.