DNR bracelet with DNR written on it. HIPAA??? - page 5

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  rnmi2004 profile page
    0
    Why not explain to the patient (or person making the decision on code status) the rationale behind the color coding & let them decide?

    Some people may be uncomfortable with the idea that a discreet identifier on their name tag may be recognized by visitors. Others may say to heck with it, it's my choice & I don't want to chance that a staff member without immediate access to the chart may initiate CPR.
  2. Visit  woody436 profile page
    0
    Isn't the same thing done with allergy bands? What's the difference?
  3. Visit  GreenCCURN profile page
    0
    We use a color coded bracelet at the facility that I work at, but we don't write anything on it. I think that a color should be enough, everyone knows what it means.
  4. Visit  SANDRA RN profile page
    0
    I think its a great idea. we have arm bands for allergies, fall risks and one to alert the nurse if pt needs a flu or pneumonia vaccine, but to know if the pt is a dnr you have to find the chart then find the order.
    Having dnr written on the armband shouldn't be anymore of a hippa violation than having their name and medical record number on one.
  5. Visit  Virgo_RN profile page
    0
    I think a color coded armband is a good idea, but what about limited code status? Also, isn't the code status of each assigned patient something a nurse should make a point of knowing at the beginning of the shift?
  6. Visit  SANDRA RN profile page
    0
    In the ICU I know the code status of my patients, but when census is low or the unit is closed, we are often asked to float to med-surg. If I walk into a patient's room on the med-surg floor and find them not breathing, it would be helpful to be able to tell immediately if the patient is a DNR or not.
  7. Visit  Pat_Pat RN profile page
    0
    Why couldn't the code status be placed on the patients ID bracelet? Everything on there is "protected" is it not?
    We put red bracelets on patients who are or may receive blood, it has numbers to match them to the units they are matched to. Is this a violation?
  8. Visit  elthia profile page
    2
    Quote from Pat_Pat
    Why couldn't the code status be placed on the patients ID bracelet? Everything on there is "protected" is it not?
    We put red bracelets on patients who are or may receive blood, it has numbers to match them to the units they are matched to. Is this a violation?
    http://www.hhs.gov/hipaafaq/administrative/200.html
    For example, the Privacy Rule does not prohibit covered entities from engaging in the following practices, where reasonable precautions have been taken to protect an individual’s privacy:


    Maintaining patient charts at bedside or outside of exam rooms, displaying patient names on the outside of patient charts, or displaying patient care signs (e.g., “high fall risk” or “diabetic diet”) at patient bedside or at the doors of hospital rooms.


    HIPAA allows us to display pt care signs at the doorway. So a hospital could probably post a discreet DNR sign at the door or the head of the bed...so I am pretty sure a DNR armband is definitely NOT violating HIPAA.
    Pat_Pat RN and Altra like this.
  9. Visit  lamazeteacher profile page
    0
    Quote from bethem
    I'm Australian, and we don't have HIPAA itself, but we do have privacy laws. Due to these laws, we cannot make any indication, even in 'code' like a coloured bracelet, that a patient has decided to become NFR (not for resus). We have the NFR order in the notes and it is handed over each shift so the nurse caring for the patient is aware, but we don't make any other indication.

    In regards to the bracelets, even if you don't have DNR on them, what would you say to a family member if they asked you why their mum or dad had this extra blue bracelet on?
    __________________________________________________ ________
    Family members should probably directed to the one closest to the patient, who would make that decision about explaining it, if the patient hasn't said they don't want others to know. However, care must be taken now, that lead isn't in the colouring of the bracelet - not that missing an IQ point wouild bother a moribund patient, but many hospital workers have to touch them when identifying the patients, and it would be nice if we retained as much IQ as we can......

    DNR is something that belongs in the chart.

    Don't feel bad that Australia hasn't got HIPPAA! It's a bad joke here, as the true purpose of the thing, is to trick people into signing permission for medical information to be given to any government agency, insurance company, etc. How it hasn't offended more people, is confounding to me, that our government thinks we're stupid enough (and many of us are) to think patients have to sign something, for someone else to keep their oath of confidentiality that is intrinsic to their profession.
  10. Visit  Agnus profile page
    0
    Quote from jlsRN
    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 strongly that this is a violation of patient privacy. It advertises to any visitor that the patient has made the decision to be a DNR. I was very vocal about my feelings regarding this. I was the only bedside nurse in the meeting. I think this is basically 'outing' the patient to the world. Many members of the public know what DNR means. It can cause dissension between family members, it can cause people with more extreme views regarding extension of life to make trouble for decision making family members, and it's making visable to any visitor the private information of the patient.

    I feel strongly that a blue bracelet should suffice to communicate with members of the healthcare team and that adding DNR to the bracelet is wrong.

    Any imput on this would be appreciated.
    That being the case any arm band displays personal information. Allergy, fall precautions, blood bank, and the id band. We can carry hippa too far.

    There are some drawbacks to a DNR arm band but you did not mention any real ones. I am sorry but DNR armbands with DNR written on them are used many places (most place I have worked) I have never run up against any of the problems that you argue.
  11. Visit  P_RN profile page
    1
    I did work acute care for 22 years and I am aware that the need exists for some ready access. However:

    My mother is 89 years old, has alzheimers and is in a nursing home. I've had a terrible cold and haven't been to see her for 6 days until yesterday.

    Clearing out her closet I found her "stash" of found objects (all hers according to her). 3 water pitchers belonging to others. 1 man's hat I have no idea where it came from, but it had her name on it in magic marker, and one name band that had the previous (deceased) resident's name on it. I clean out her closet and chest of drawers every time I go. Now I wonder in the above situation, if she were to "find" a blue band and put it on because it is a pretty color???..... and I do know ECFs are different from acute care.
    FireStarterRN likes this.
  12. Visit  CyndieRN2007 profile page
    0
    I think the color code is enough. However, I have to agree with the poster who said its not a HIPPA violation.
  13. Visit  NRSKarenRN profile page
    2
    This is NOT a good idea....see:


    Pennsylvania Patient Safety Authority - Supplementary Advisory -Use of Color-Coded Patient Wristbands Creates Unnecessary Risk
    http://www.psa.state.pa.us/psa/lib/p...ec_14_2005.pdf
    P_RN and FireStarterRN like this.

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