Three sources, one identity

Positive identification is not one check, it is a reconciliation of three independent sources: the order or requisition, the wristband applied to the patient, and, for a conscious patient, the identifiers the patient states unprompted. CLSI PRE01 calls for the organization-approved process and for asking the patient to state identifiers rather than reading them aloud and asking for agreement, because a patient who is asked "are you John Smith?" may answer yes out of politeness or confusion even when it is wrong.

None of the three sources is a trusted default that overrides the others. A wristband, an order, and a verbal response are evidence to reconcile, not interchangeable substitutes, and when they disagree the collection is not safe to begin. Unconscious patients, pediatric patients, a language barrier, an emergency registration, an unknown patient, and a wristband discrepancy like the one in the opening case all need the organization's approved identification pathway rather than an improvised workaround, because each of these situations removes one of the normal three-source checks and the approved pathway exists precisely to cover that gap.

The process map below lays out the full sequence from the first identifier check to specimen handoff. Every later section adds detail to one or more of these steps; none of them disappears once the learner moves past it.

Treat a discrepancy as a stop condition first and a puzzle to solve second, because the safest specimen is the one drawn from a correctly identified patient every time.