| Course | NSG 633 Safety and Quality |
|---|---|
| Unit | Unit 5 |
| Paper type | Patient identification audit |
| Length | About 1,010 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 633 Unit 5
Two Identifiers at the Moment of Care: A Standard-First Audit of 24 Observed Opportunities for Medications and Bedside Glucose Checks
Student Name
Department of Nursing, Herzing University
NSG 633: Safety and Quality
Instructor Name
February 11, 2026
Two Identifiers at the Moment of Care: A Standard-First Audit of 24 Observed Opportunities for Medications and Bedside Glucose Checks
The Requirement, in the Standard's Own Terms
The standard used here is the patient identification goal published by the Joint Commission among its National Patient Safety Goals. It requires staff to use at least two patient identifiers when giving medications, blood, or blood components, when collecting blood samples and other specimens, and when providing treatments or procedures (The Joint Commission, 2024). The standard specifies three points that shape this audit. First, the identifiers must be specific to the person, such as full name and date of birth; a room or bed number is not an identifier. Second, identification is tied to the person receiving care, so the identifiers on the wristband or the specimen must be matched to the order or the label. Third, the requirement applies at the moment of care, not at admission. A wristband checked when a patient arrives does not satisfy the standard at 0900 when a medication is given.
The standard does not say that a barcode scan is itself verification. A scan confirms that the wristband and the order match in the system; it does not confirm that the wristband is on the right person. The audit therefore treats the scan and the identity check as separate behaviors.
Turning the Requirement Into Observable Behaviors
Four behaviors were defined before observation began, each visible to an observer standing in the room:
A. The nurse asks the patient to state full name and date of birth, rather than reading them aloud and waiting for agreement. (For a patient who cannot answer, a second staff member or a family member confirms, and the observer records which.)
B. The nurse compares the stated identifiers with the wristband.
C. The wristband barcode is scanned before the medication or test is given.
D. The electronic record shows the scan and the administration or result under the same patient.
Behaviors A and B are practice; C is a mix of practice and system; D is documentation. The audit counts each separately.
The Observation Record
Observations were made on the composite medical floor over two 0800 to 1000 windows on consecutive weekdays, by a student observer with the charge nurse's permission and the nurses' verbal agreement. Opportunities were counted as each separate medication administration event or point-of-care glucose test. Twenty-seven opportunities occurred in view; three could not be seen because the curtain was drawn for privacy, leaving 24 observed. No patient or nurse is identified.
| Behavior | Medication administrations (n = 16) | Glucose checks (n = 8) | All observed (n = 24) |
|---|---|---|---|
| A. Patient states name and date of birth | 10 | 3 | 13 |
| B. Stated identifiers compared with wristband | 11 | 4 | 15 |
| C. Wristband scanned before care | 16 | 7 | 23 |
| D. Scan and event recorded under same patient | 16 | 8 | 24 |
| Could not be observed (curtain drawn) | 2 | 1 | 3, excluded |
Findings, Sorted
Recorded but not done. In 11 of 24 opportunities the record shows a scan and an administration, which is complete documentation, but the patient was not asked to state identifiers. In most of these the nurse read the name aloud ("You're Mrs. ___, right?") and the patient agreed. Leading identification of this kind lets a confused or hard-of-hearing patient agree to the wrong name, and in a simulation study, identification errors were common even among experienced nurses who believed they were checking (Henneman et al., 2010). This is a practice gap that the documentation hides completely.
Done but not recorded. In one glucose check, the nurse asked for name and date of birth and compared them with the wristband, but the meter's scan failed and the patient identifier was typed in manually. The result posted correctly, but the record shows a manual entry, which looks like a workaround even though the identity check was done properly. Manual overrides are a known workaround in barcode systems and are usually counted as failures without asking what happened at the bedside (Koppel et al., 2008).
Neither. One glucose check was done without a scan or a stated-identifier check; the meter was used on a patient whose name the nurse knew from the previous day. It is the only observation in which neither the practice nor the record met the standard.
Patients who could not state their identifiers. Two of the 24 opportunities involved patients who could not reliably answer: one with advanced dementia and one who was drowsy after a night of poor sleep and a sedating medication. In the first, the nurse checked the wristband against the medication record and asked a family member at the bedside to confirm the name, which meets the intent of the standard. In the second, the nurse scanned the wristband and gave the medication without any spoken confirmation from anyone. These two opportunities are counted in the totals above, but they are worth separating, because the patients least able to correct a wrong name are the ones for whom spoken identification is hardest and most often skipped. A floor policy that names who confirms identity when the patient cannot, and how that is recorded, would close a gap the current count only partly shows.
The pattern is clear: documentation is strong (24 of 24) and practice is weaker (13 of 24 for behavior A). An audit based only on the record would have reported full compliance.
What 24 Observations Can and Cannot Support
Twenty-four opportunities over two mornings support one claim: on this floor, at this time of day, asking patients to state their identifiers was often skipped even when scanning was done. They do not support a rate for the floor, since night shift, weekends, and evening medication passes were not seen, and 24 is too small for a stable percentage. They cannot support any conclusion about individual nurses, and none is drawn. The observer's presence probably improved behavior, since people change what they do when they know they are being watched (McCambridge et al., 2014), so the real gap is likely larger, not smaller.
The finding points to a documentation-versus-practice fix, not a "nurses must try harder" fix. Two options fit: adding a prompt on the scanner screen that asks "Did the patient state name and date of birth?" before the scan is accepted, and including stated identification in the next month's observation audit, with at least 60 opportunities across all shifts, before anything is concluded.
References
Henneman, P. L., Fisher, D. L., Henneman, E. A., Pham, T. A., Campbell, M. M., & Nathanson, B. H. (2010). Patient identification errors are common in a simulated setting. Annals of Emergency Medicine, 55(6), 503-509. https://doi.org/10.1016/j.annemergmed.2009.11.017
Koppel, R., Wetterneck, T., Telles, J. L., & Karsh, B.-T. (2008). Workarounds to barcode medication administration systems: Their occurrences, causes, and threats to patient safety. Journal of the American Medical Informatics Association, 15(4), 408-423. https://doi.org/10.1197/jamia.M2616
McCambridge, J., Witton, J., & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267-277. https://doi.org/10.1016/j.jclinepi.2013.08.015
The Joint Commission. (2024). National patient safety goals effective January 2024: Hospital accreditation program.
NSG 633 Unit 5 instructions, in plain terms
Unit 5 asks you to audit one safety practice against a written standard. Expect to state the requirement in the standard's terms, define observable behaviors before watching, record observations, sort findings and state what the sample supports. Students often ask how many observations are enough and whether to rely on the record. Twenty to thirty observations give a picture of one unit at one time, not a rate for the hospital. Define behaviors before observing so findings are not shaped afterward. Compare what the record shows with what you saw, since charting can show checks that did not happen. Get permission to observe and keep staff unidentifiable. Include what happens with patients who cannot state their own name.
Inside the NSG 633 Unit 5 example
The audit opens with the standard quoted and its key terms explained. The behavior section lists four observable actions defined in advance. The observation section describes when, where and how opportunities were counted. The findings section sorts results, with the gap between recorded and observed checks given first because it matters most. Other findings include scanning without asking and asking for name only. The limits section explains that two mornings on one unit support a narrow claim. Each count comes from the observation record, so the audit can be checked, and staff are described by role only. Patients who could not answer were checked against the wristband and a second staff member, and these are counted separately.
Where the points sit in the NSG 633 Unit 5 rubric
Herzing's rubric for an identification audit usually covers the standard, observable behaviors, the observation method, findings, the record-versus-practice comparison and limits. The comparison between what was charted and what was seen draws the closest reading, since it reveals a risk the record alone would hide. Standard points reward the requirement quoted accurately. Behavior criteria look for definitions set before observing. Method earns credit for clear windows and counting rules. Findings should give counts over the number of opportunities. Limits points go to an honest statement of scope. Staff anonymity is expected. The Joint Commission's patient identification goal and Phillips's study support the audit.
Common NSG 633 Unit 5 mistakes, and how to avoid them
Identification audits in Unit 5 often slip by defining behaviors after observing, which lets the findings shape the method. Another frequent problem is relying on the record instead of watching. Students often report percentages without the count of opportunities. The standard is paraphrased loosely, such as check the patient's identity. Limits are not stated, so a two-morning sample is treated as a hospital rate. Staff are identifiable. Bedside tests such as glucose checks are left out, though they need identification too. Findings are not sorted by importance. Patients who cannot state their name, such as confused patients, are not addressed. Finally, compare the chart with what you saw, because graders reward an audit that finds the gap between recorded safety and real practice.
Get a NSG 633 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NSG 633 classroom, along with the standard the course expects the audit to use. We write a custom example that quotes the requirement first, converts it into observable behavior, states the denominator and separates documentation from practice. First custom sample free, back in 24 to 48 hours.
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NSG 633 Unit 5 questions, answered
Can you supply the observations?
No. What happens on a floor is watched by the person standing there, and an example arriving with counts already inside it would be inventing them. The sample carries a composite record so the table, the denominator and the sorting have a shape, and you replace the rows with what you actually saw.
How many observations make an audit?
Follow the count in the instructions, and where none is given, say plainly what your number supports. A small series can show that a behavior varies and can find a documentation gap; it cannot produce a rate for a floor. Stating that limit usually scores better than a confident percentage drawn from a handful of opportunities.
Which standard should the audit read?
The one your course names, and where the choice is open, a published national requirement rather than a local policy, since internal documents cannot be quoted in a submitted file. Name the version and the date you read it, because identification requirements are revised and an audit written against superseded wording measures the wrong thing.
Where can I find a free NSG 633 Unit 5 sample paper?
The full NSG 633 Unit 5 identification audit is free on this page, 24 opportunities checked against the two-identifier standard. Ask for a custom audit of another safety practice.
What are the two patient identifiers?
Usually the patient's full name and date of birth, confirmed at the moment of care, often with a wristband scan. This sample audits 24 opportunities and finds scans recorded where no verbal check was observed.