DNR bracelet with DNR written on it. HIPAA???

Nurses HIPAA

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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.

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.

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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.

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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.

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Specializes in PeriOp, ICU, PICU, NICU.

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.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.
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.

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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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Good point. and YES a verbal order! I called the doc because the son was in earlier and said he wanted his dad a DNR. Son had to leave and couldnt wait for doc to call me back. So..the doc called me, I explained the situation and gave the doc the son (who is POA) cell number. the doc called the son and confirmed he wanted his dad a DNR. So the doc gave me a verbal order to make pt a DNR, I had to have another nurse confirm and we signed the form like a verbal order. The doc came in the next morning and signed off on it. Its a mid-size hospital..about 365 beds. Its part of a large network of hospitals.

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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.

All these color coded stuff going around. I like what we did. One color, white. client's name, room # and DR. ...reason for that is that code status may change and what if someone forgets to update the bracelet.

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Hey guys,

I'd like to revisit this issue for a bit. I'm a doctoral student in nyc and want to do a paper on ineffective communication of DNR status, to prevent wrongful resuscitation by nurses who are unaware of the patient's status due to it being the wrong patient/nurse.

This is NOT about a nurse not knowing her own patient's code status! That is entirely different. This is about a unit-wide policy that should be in place to prevent resuscitations on patients who are found unresponsive when the nurse is not around, on break, or off the unit. (This does extend to patient admissions from other facilities, or transfers to other floors or facilities.)

However, I am running into trouble doing research on this particular aspect of DNR's. It seems I'm not talking about a rare situation, though, because in 8 pages of this topic, nurses seem to indicate that a need for communication (signs, wristbands) are necessary.

Anyone have any info that may be of help? Even search terms that may yield results? Every try simply gives me some study about effective communication about DNR's between physician and patient, blah blah blah.

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Specializes in NICU, PICU, PACU.

What does your legal department have to say about it? We had to go thru ours and we have preprinted bands that we use that say DNR-CC, etc. We even post them on our isolettes. They said that is the along the same line as their ID band with their info on it.

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I don't think it's a violation. Patients have their names, birthdays and account numbers on their bracelets.

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Specializes in psych, addictions, hospice, education.

Wouldn't having a specific color be good enough without putting the letters on it? With punches as WSU Ally mentioned for the 3 types.

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