DNR bracelet with DNR written on it. HIPAA??? - page 3

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... Read More

  1. Visit  MNmom3boys profile page
    0
    Quote from jlsRN
    If the employees of the hospital are not able to learn that blue means 'no code' then they are probably not qualified to start a code.
    Agreed, and blue is pretty intuitive. (Code blue, et al)

    However, what about confusion for travelers, new hires, nurses working for two (or more) healthcare systems, etc. that may be used to a different color "system" ie the yellow bracelet discussed earlier in the thread. I'm not saying they can't learn, I'm concerned that their inital "move now" (or not) response may be slowed down because they are looking for a different color. FWIW
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  3. Visit  txspadequeenRN profile page
    0
    this is a hipaa violation ..everything you have mentioned here is in violation of confidentiality. anyone can walk in these rooms and get information if they are just left hanging around. not to long ago anything that had the patients name on it had to come down at my job including the names outside the door, names on the outside of the charts and anything else that could identify a patient.




    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.)
    however, ethically...it's stupid to write dnr on the bracelet. i agree with the op, the colored band is appropriate and sufficient.
  4. Visit  KyPinkRN profile page
    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.......
    You have a good point that it isn't up to the passer by, we should all know the pt's code status... but what about when the patient is off the floor for say an xray or something, a bracelet would be good in this instance for someone who doesn't know the patient well, or sees numerous pt's over the course of the day.
  5. Visit  tommycher profile page
    2
    When and if a pt goes bad, there often is not the time to discern color codes, you absolutely have to know, without a doubt, what this pt's wishes are. We do use a blue bracelet, with DNR or No Code written on it, with two nurse's signatures next to it, in order to ascertain without a doubt what the Dr.'s order, and the pt and or family's wishes were. I have attended many codes, and they happen quickly, and not all staff are that well versed in the meaning of bracelet colors, and when a code is called, many people come quickly. This is not a HIPPA violation as far as I am concerned, it is ensuring the pt will not suffer undo trauma in the event of death. What would be more tragic, and I have seen this, is the uncertainty of the pt's code status, and the family is devastated when their family member has broken ribs, and brain damage, due to people with adrenaline rushes NOT checking what the bracelets had written on them. In that event, the family is left to make choices they did not want to have to deal with.
    Scrubby and Altra like this.
  6. Visit  sjt9721 profile page
    0
    Quote from ayla2004
    pt will only have a max of 2 braclets
    white = id
    white/red id but the pt has an allergy which is in the notes
    orange= infection mrsa/c.diff being the most common. infection is not named on braclet
    Haven't seen a bracelet yet for isolation patients. Hmm..

    We also "band" our pediatric patients with the color that corresponds to their appropriate Broselow color.
  7. Visit  Altra profile page
    0
    Quote from sjt9721
    We also "band" our pediatric patients with the color that corresponds to their appropriate Broselow color.
    I'm not too keen on being bracelet-happy and color-coding people for every little thing ... but if you're going to use bracelets ... I like this idea.

    I like it for the same reason that I don't have a problem with DNR on a bracelet -- these bracelets become functional in critical, time-dependent situations when seconds could make a difference. If the Broselow cart can be cracked & opened immediately with the step of laying the kiddo next to the Broselow tape already done, all the better.
  8. Visit  blueheaven profile page
    1
    Quote from GregRN
    Not to be rude but...so what? What's wrong with patients making their wishes known to the entire world? I would think that's what the patient wants, that if they were to code in such a manner that required intubation or "heroic measures," they would want the world to know to let them go peacefully without the threat of trauma or lengthening their life with no added quality to it. If those were my wishes and my ability to make this decision while of sound mind were all I had left, and my will and legacy depended on it, I would want everyone to know it, regardless of whether they were part of a health care team or not.
    Here in MD we have a bracelet we place on pts. who are being transported to another facility that has written DNR in small lettering along with a legal document that states the same.

    One of the more frightening things for my dad (when he was alive) was something happen and he die out on the street and someone would try to resusitate him. He half laughingly talked about getting NCB or DNR tattooed on him.
    Sugar Magnolia likes this.
  9. Visit  YellowFinchFan profile page
    0
    Quote from JennyLR
    You have a good point that it isn't up to the passer by, we should all know the pt's code status... but what about when the patient is off the floor for say an xray or something, a bracelet would be good in this instance for someone who doesn't know the patient well, or sees numerous pt's over the course of the day.

    Well, at our facility the patient's chart goes with the patient for any testing - code status (if DNR or versions of such) are in front of chart when opened. ALso, computer would have status...and most likely if your patient was off floor for ultra sound - and a code blue is called - the RN or charge from our floor would respond to that area.

    It's not a perfect system-but it's a huge deal on our floor to know the code status of our patients since we see so many....unfortunately.
  10. Visit  YellowFinchFan profile page
    0
    Quote from MLOS
    I'm not too keen on being bracelet-happy and color-coding people for every little thing ... but if you're going to use bracelets ... I like this idea.

    I like it for the same reason that I don't have a problem with DNR on a bracelet -- these bracelets become functional in critical, time-dependent situations when seconds could make a difference. If the Broselow cart can be cracked & opened immediately with the step of laying the kiddo next to the Broselow tape already done, all the better.

    Even if we used a bracelet system like this for DNR on our unit we still MUST see the legal document in the chart - with the MD in charge and RNs confirming code status - legally even the DNR in the computer it still must be backed up with signed paper document.....in a court room the color of the patient's bracelet wouldn't hold up.

    We had a potential code this week - unpleasant in that not all of the family was comfortable with the DNR status completely and we spent a great deal of time going over the MD notes/DNR to make sure things were all legal- while we worked on patient and family stood outside room -- thanks to our rapid response and interventions short of intubation and drugs needed the patient survived to live another day.
  11. Visit  tommycher profile page
    0
    Have you ever seen a code run on a pt that a nurse forgot to put the DNR bracelet on? I have, and the hospital is still in litigation over this. A doctor's order says DNR, and two nurses sign the order and the bracelet, unless the nurse is negligent. This is very sad, and happens all the time.
  12. Visit  ncmc3132 profile page
    0
    adding DNR to the bracelet would be a HIPPA violation---a color coded bracelet is all you need
  13. Visit  blueheaven profile page
    0
    Quote from YellowFinchFan
    Well, at our facility the patient's chart goes with the patient for any testing - code status (if DNR or versions of such) are in front of chart when opened. ALso, computer would have status...and most likely if your patient was off floor for ultra sound - and a code blue is called - the RN or charge from our floor would respond to that area.

    It's not a perfect system-but it's a huge deal on our floor to know the code status of our patients since we see so many....unfortunately.
    It is a huge deal, I transferred a patient to regular floor one time, and 2 hours later they called a code for her room, I ran down the stairs before they could really get going...she was a DNR, they thanked me because "she just got here" and they didn't really know. I know I told the primary nurse

    I work in an ICU so if the patient is off unit, one of the nurses is with him/her. A bracelet would help if it was a pt coming from a regular unit. Usually if we are sending someone out of our facility, we send a copy of the chart (not the whole chart) because we use exclusively computerized charting, and if they were DNR they would also have a bracelet on (state regs)
  14. Visit  kukukajoo profile page
    0
    Speaking of DNR, Here in NH we have a portable wallet sized DNR card! It is hot pink and is signed by the doc and if you ask me the best thing to come along in a very long time!


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