Patient Identification Form - Infection Control Services Ltd 2026

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  1. Click ‘Get Form’ to open the Patient Identification Form in the editor.
  2. Begin by entering the Hospital No and Ward at the top of the form. Ensure these details are accurate for proper identification.
  3. Fill in the NHS No, followed by the Patient’s Name. Clearly print both last and first names to avoid any confusion.
  4. Indicate the patient's gender by selecting either Male or Female. Next, enter the Date of Birth (DOB) and Age.
  5. Provide the Patient’s Religion in the designated field, ensuring it is legible.
  6. Record the Date and Time of death, as well as the Date and Time of removal to mortuary. These fields are crucial for documentation.
  7. Complete sections regarding admission date, nurse's name and signature, porter’s name, consultant’s name, and diagnosis status.
  8. Finally, answer questions about high risk/danger of infection and property on patient. Provide details where necessary.

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Colleagues should refer to the list of core patient identifiers below when confirming or verifying a patients identity: last name. first name. date of birth. NHS number.
The 5 Fs, that infectious diseases are transmitted from one person to another are through food, finger, fluid, fomite, and faeces. A major public health concern is that infectious diseases affect children more frequently.
If patient identification bands are not practicable or appropriate, health services may use equivalent means of identification. Any alternatives must contain the three nationally agreed core patient identifiers (name, date of birth and medical record number).
Patient identification is the process of correctly matching a patient to appropriately intended interventions and communicating information about the patients identity accurately and reliably throughout the continuum of care 1 .
It is recommended to use PID-3 - Patient Identifier List for all patient identifiers. PID-3: Patient Identifier List (CX) 00106. PID-6: Mothers Maiden Name (XPN) 00109. PID-7: Date/Time of Birth (DTM) 00110. PID-8: Administrative Sex (CWE) 00111. PID-10: Race (CWE) 00113. PID-15: Primary Language (CWE) 00118.

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Acceptable identifiers may be the individuals name, an assigned identification number, telephone number, date of birth or other person-specific identifier. Use of a room number would NOT be considered an example of a unique patient identifier.

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