complete chemotherapy orders include a second identifier. a second identifier is the date of the
The Correct Answer and Explanation is:
Answer: The second identifier is the patient’s date of birth.
Explanation
In chemotherapy ordering—and in virtually all areas of medication administration—using at least two patient identifiers is a foundational safety practice. The primary identifier is commonly the patient’s full name. The second identifier is most reliably the patient’s date of birth. This dual‐identifier approach helps ensure that the right treatment is given to the right individual and minimizes the risk of serious errors, such as administering chemotherapeutic agents to the wrong patient.
First, chemotherapy drugs are often high‐risk medications with narrow therapeutic windows and significant toxicity. An error in patient identification can lead to administering a drug intended for another individual, which could have disastrous—or even fatal—consequences. For instance, giving a myelosuppressive agent to someone who does not need it could precipitate severe, unnecessary bone marrow suppression; giving the wrong drug could fail to treat a person’s malignancy. By requiring both the patient’s name and date of birth, clinicians and pharmacists add a redundant check before drawing up, verifying, and dispensing chemotherapy.
Second, date of birth is less prone to transcription or misreading mistakes than some other identifiers (for example, medical record number or room number). Names can be spelled differently—“Sara” versus “Sarah,” “Brian” versus “Bryan”—and can lead to confusion if two patients have similar or identical names. By contrast, the date of birth is a fixed numeric value (e.g., 08/15/1972) that is uniquely associated with an individual in most electronic health record systems.
Third, regulatory bodies and accreditation organizations (for example, The Joint Commission in the United States) explicitly require hospitals and oncology units to use two identifiers when administering any medication, particularly high‐alert medications like chemotherapeutics. This approach is embedded in “National Patient Safety Goals” and oncology‐specific safety guidelines, which have been developed in response to past sentinel events involving patient misidentification.
Finally, incorporating the date of birth as a standard second identifier fosters consistency across all points of care—pharmacy order entry, nurse preparation, bedside verification, and infusion. Each staff member can independently confirm both the patient’s name band (with a picture or barcode) and date of birth before proceeding. This multilayered verification process significantly reduces the chance of an adverse event, ensuring that chemotherapy is delivered safely and precisely to the intended recipient.
