DNR bracelet with DNR written on it. HIPAA??? - page 2

by FireStarterRN 20,802 Views | 87 Comments

I was at a committee meeting today. We discussed color coded bracelets that our hospital is considering. One of them is a blue bracelet for DNR patients. It was mentioned that they also want to write 'DNR' on it. I feel... Read More


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    I'm in two minds about this. Part of me agrees with the concept, but i also see it as an invasion of the persons privacy.

    I guess that if you didnt' know the patient very well and wasn't aware that they were DNR because you weren't involved in their care, they crash and you did commence CPR then that goes against the persons wishes, and if it was me then i'd feel pretty terrible about it.

    I do agree though that it does need to be made clear in some way that they person is DNR. When I worked on the ward sometimes this wasn't handed over and i'd be looking through the notes and see a DNR order.
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    i'm in the uk and we don't have HIPPA but do have confidenaltiy laws
    are DNR are handed over each shift and and the patients ward board will have a code to indiacate their status.
    all are braclets have on them are the name DOB hospital number and ward(espially if pt is confused)
  3. 0
    as far as a hippa violation I am not so sure that it is, heck they have a bracelet on them with their name, acct number, doctor and dob. I do think it is important to know easily if a patient is dnr or not. But not sure what the answer is, we don't bracelets on. But we do if they are a fall risk, and one for allergy so the poor patient can have 3 bracelets on.
  4. 1
    Just a note . . . people aren't dumb. They will figure out what all those mysterious bracelets and colors are about. They know because THEY get hospitalized or they just plain ask. Either apply the bracelet or don't. Writing DNR on it won't make any difference. They are already "out" (as the respected poster from Australia observed).
    Altra likes this.
  5. 0
    Quote from WSU_Ally_RN
    The facility I work at, we use yellow DNR bracelets. On the bracelet, there are three types, DNR, DNR-CC and DNR-CCA. We are to use a hole puncher to punch out which one applies, and then apply to the pt. What would happen if someone that is might not be partaking in that patients care happens to witness them code... a blank bracelet may not make them aware of what their code status is and begin coding the person.

    But it wouldn't be up to the 'passerby' in the room to make the actual call that this patient is a code or no code.

    The passerby would alert someone (RN/nursingasst....anyone healthcare related in the area) that something's wrong. I've seen t his happen many times (family.visitor,security guard even) We all know the code status of our patient's, charge RN knows it...and we refer to chart/computer also for written comfirmation.

    Your bracelet thing is interesting (the diff colors and punches) but what if someone makes a mistake (it happens) I still wouldn't rely on a name band only to call a code or not....I'm sure you don't probably.

    We have the chart in the room/the computer up...all references to CODE status wishes known to MDs/RNs.

    I do think it's a Hippa violation to put DNR written on nameband. We aren't even allowed to post signs in room (I&O's) Fall risk sheets in the 'open' everything has to be covered up...hippa etc.......
  6. 0
    Quote from YellowFinchFan
    But it wouldn't be up to the 'passerby' in the room to make the actual call that this patient is a code or no code.

    The passerby would alert someone (RN/nursingasst....anyone healthcare related in the area) that something's wrong. I've seen t his happen many times (family.visitor,security guard even) We all know the code status of our patient's, charge RN knows it...and we refer to chart/computer also for written comfirmation.

    Your bracelet thing is interesting (the diff colors and punches) but what if someone makes a mistake (it happens) I still wouldn't rely on a name band only to call a code or not....I'm sure you don't probably.

    We have the chart in the room/the computer up...all references to CODE status wishes known to MDs/RNs.

    I do think it's a Hippa violation to put DNR written on nameband. We aren't even allowed to post signs in room (I&O's) Fall risk sheets in the 'open' everything has to be covered up...hippa etc.......
    If the passerby is an employee then they would start the code and while calling for help. I would hope so, anyway. And even housekeeping can initiate CPR until help arrives, so yes, it would be important for them to know code status.

    I've seen codes started by a nurse walking into a patient's room that wasn't hers only to find out the patient was a DNR because there's no time to go running looking for a chart or finding the regular nurse to ask. Same with PT or OT. They two can call for help and start CPR when they're with a patient and won't necessarily know the code status. Or transport. They know CPR too, and they don't usually have access to charts.
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    What you are intending to do is communicate to health care workers that the patient is a DNR. Its all well and good if DNR is not written of the band and the patient codes on your unit. What if they go to xray or some other department . It is true that all employees SHOULD know what the bands are but it would sure be a lot easier if it were written on the band. I think it is a need to know thing and if a patient is coding I don't want to be looking at an arm and have any question about whether the patient is to be coded or not. As far as I&O sheets go I'm sure glad the hospital where my mother was hospitalized had her I&O sheet hung up. The nurses sure did not catch that she had no output for a whole shift with a fc and lasix ordered q8h.
  8. 0
    Quote from Kunzieo
    This is NOT a HIPAA violation...(think of I/O sheets, lab-draw sheets, charge sheets, etc that hang in the room...legally, it's akin to that.)
    We don't have any sheets of that nature hanging in our rooms for people to see!!
  9. 0
    we cut out all those colored bracelets. Too confusing and expensive and they get in the way. It is up to the appropriate staff to know about allergies and DNR orders, etc. This info is in patient chart and given in report and when handing off patient to another person (transport, etc) on an "as needed basis". But as to privacy, it is up to the patient at all times. So if they don't mind why should you? What about people who wear jewelry identifying them as diabetics or heart patient or with severe allergies?
  10. 0
    The facility that I am at uses green bracelets for fall risk, along w/ ID bracelet and red drug allergy bracelet. How long before we 1)run out of arm space and or colors or 2) (and this I actually am concerned about-) someone forgets which color signifies what?

    I know privacy is important, but if they have made the effort to make a decision and declare a DNR status it needs to be clearly marked somewhere what their wishes are. (Charts are not always accessible and/or w/ patient.)


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