DNR bracelet with DNR written on it. HIPAA??? DNR bracelet with DNR written on it. HIPAA??? - pg.6 | allnurses

DNR bracelet with DNR written on it. HIPAA??? - page 6

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  lamazeteacher profile page
    #65 0
    Quote from P_RN
    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.
    __________________________________________________ ____________

    Your mom sounds like she might be DNR..... Is she? So unless there is another colored bracelet for patients who are to be resuscitated, if she found a band that indicated DNR, no harm done.

    Also, I'm an advocate of family conferences with clergy when DNRs have been signed, so even if a few relatives are against it, they've had their say, and know the choice isn't theirs......
  2. Visit  lamazeteacher profile page
    #66 0
    Quote from tddowney
    Exactly. The Pt's choice has to be communicated to those that could follow/not follow it.

    In the magic world inhabited by lawyers and commissions, every caregiver can remember the code status of Pts with perfect accuracy, along with their fall risk, allergies, which arm has a new, immature AV fistula, etc.

    For a nurse on the floor, with 5 Pts that change every shift, such a world is laughable.
    __________________________________________________ _________
    It might help, if patients are to be on the same unit for at least 3 - 4 days, if the names of those who are DNR got on a list in the "crash" cart, by the ambou bag and that would warn off anyone who thought they needed CPR. Also if at each shift change, the list was read at report (it can't be that long), staff would become familiar with those names.

    I'm not as concerned about privacy (after all, it's the speaking/ sharing of written patients' information that's not allowed), as I am about the unintended breaking of fragile ribs during compressions, of those who perhaps for that reason, want DNR. If the patient survived, and subsequent pain from the broken ribs made their last days intolerable, someone in the family could cry "lawsuit!":uhoh21:
  3. Visit  P_RN profile page
    #67 0
    Mama is actually cpr only. No intubation. So for all purposes she's DNR. But she still walks on her own with a rolling walker, plays Bingo etc. keeps track of her hair appts, draws-both pencil and pen and ink. And takes ONE med-a vitamin. But the point is just the bracelet isn't sufficient. Perhaps the admitting band could be blue, thus have the name, unit re. #, adm # etc.
    Whenever I have been hospitalized here I always get my bracelet and it's orange (fall precautions).
    But at MUSC when I had an ercp, orange was for the GI dept.and fall risk was purple. So everyone would need to be one the same sheet of music.
  4. Visit  FireStarterRN profile page
    #68 0
    I guess my main concern is for the dignity of my patients, no matter what their stage of life is. There is something dehumanizing and inpersonal about slapping a bunch of bracelets on people, and then inscribing DNR is kind of like marking a tree in the forest to be cut. It just strikes me as wrong.
  5. Visit  Pat_Pat RN profile page
    #69 0
    Quote from NRSKarenRN
    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
    What I get from this is that everyone needs to get together on color...OR WRITE IT ON THERE!!

    The problem we have in the ER at our facility is trying to get the Code status from the nursing homes...geez!
  6. Visit  Diary/Dairy profile page
    #70 0
    Quote from NRSKarenRN
    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
    Karen, thanks -that was an intersting article - I am going to pass it onto the unit manager here - we use pink bands. They do not indicate code status, but rather that something is different about it, and that you need to check the orders for complete details.
  7. Visit  caliotter3 profile page
    #71 0
    The color should be enough. And even so, it wouldn't be long before the word got out what the color coded band meant. But still the letters DNR would not be there for all the world to see.
  8. Visit  WeimaranerluvinRN profile page
    #72 0
    Just my opinion but those bracelets are so small unless someone is super nosey and walks right up and grabs the patients arm to check their bracelet out I don't think that it's a big deal.
  9. Visit  lorabel profile page
    #73 2
    I agree....color bracelet only! My reason is...I had a situation where the son of my patient was POA. We did a verbal order to make the pt a DNR...The son did not want his cousin who lives nearby to know that her uncle was a DNR. the son stated she would only make all kinds of family trouble if she knew. The pt. was in renal failure, had a pressure ulcer stage IV that was going to the bone, and many more issues. Well....the neice found out from another nurse that he was made a DNR and she caused much turmoil in the family just as predicted. Ultimately, the pt. went home on hospice but the son was VERY angry with the nurse. The nurse should have seen the note on the kardex stating POA requests no other family members know of code status.....this was a doctor's order! It should have been passed on in report, maybe it was, I dont know..but the point is..the son was POA and he had good reason to keep code status confidential. So...it may vary from case to case..........but I think due to HIPPA color coded bracelets are enough.
  10. Visit  lpnstudentin2010 profile page
    #74 0
    yes have braclets. I see no difference between allergy braclets (which as a patient I wear everytime I go to the hospital with no prob, i would rather wear it and everyone know DONT GIVE THIS PERSON SUCH AD SUCH) and DNR braclets. And if there is a problem with different hospitals using different colors then make it a statewide policy.
    Last edit by lpnstudentin2010 on Jan 20, '08
  11. Visit  Jessy_RN profile page
    #75 1
    We use a purple arm band and that's it. Red is allergies with them written on them and yellow is high fall risk. I agree, no need to write DNR.
  12. Visit  FireStarterRN profile page
    #76 0
    Quote from lorabel
    I agree....color bracelet only! My reason is...I had a situation where the son of my patient was POA. We did a verbal order to make the pt a DNR...The son did not want his cousin who lives nearby to know that her uncle was a DNR. the son stated she would only make all kinds of family trouble if she knew. The pt. was in renal failure, had a pressure ulcer stage IV that was going to the bone, and many more issues. Well....the neice found out from another nurse that he was made a DNR and she caused much turmoil in the family just as predicted. Ultimately, the pt. went home on hospice but the son was VERY angry with the nurse. The nurse should have seen the note on the kardex stating POA requests no other family members know of code status.....this was a doctor's order! It should have been passed on in report, maybe it was, I dont know..but the point is..the son was POA and he had good reason to keep code status confidential. So...it may vary from case to case..........but I think due to HIPPA color coded bracelets are enough.
    Thanks for the example. This is just the type of problem I foresee.
  13. Visit  elthia profile page
    #77 1
    Quote from lorabel
    I agree....color bracelet only! My reason is...I had a situation where the son of my patient was POA. We did a verbal order to make the pt a DNR...The son did not want his cousin who lives nearby to know that her uncle was a DNR. the son stated she would only make all kinds of family trouble if she knew. The pt. was in renal failure, had a pressure ulcer stage IV that was going to the bone, and many more issues. Well....the neice found out from another nurse that he was made a DNR and she caused much turmoil in the family just as predicted. Ultimately, the pt. went home on hospice but the son was VERY angry with the nurse. The nurse should have seen the note on the kardex stating POA requests no other family members know of code status.....this was a doctor's order! It should have been passed on in report, maybe it was, I dont know..but the point is..the son was POA and he had good reason to keep code status confidential. So...it may vary from case to case..........but I think due to HIPPA color coded bracelets are enough.
    VERBAL ORDER for DNR???? where do you work that allows that?

    Color coded bracelets are dangerous...the meaning of the color changes from place to place. DNR written out is much safer.

    Unfortunately there will always be families that have unstable dynamics and turmoil, but look at it this way...if the pt's heart quit beating while the niece was in the room...the family would have figured out REAL quick the pt was a DNR when the staff refused to perform CPR. Can you imagine what that scene would be like.

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