Bracelets in the NICU

[kandrien]

I work in a level three NICU. Our babies are born in house and must have 2 identification bracelets on before they leave the DR. They are the kind that have a printed number that matches the mother's and father's with a slide in insert with name, MR#, etc, then we must put a med bracelet on each baby. As our babies grow the bracelets get tight, they smell over time and leave marks. We have to replace them with the same type of bracelet. My question to all of you is what kind of bracelet system do you use on your preemies? Do your preemies have three bracelets on all the time? Does anyone know what is JACHO requirement?

[labordude, BSN, RN]

We don't put the bands on the preemies. They are typically stapled or paperclipped together and attached to the inside of the isolette. The L&D nurses have learned not to try to slap bands on babies that are coming to the NICU because half the time we rip them off anyway. There is no such thing as a JCAHO requirement for ID bands. The Patient Safety Goal related to patient identification deals with the "what" of identifying a patient, not the how. The how (in your hospital case, the identification bands) is up to facility policy.

[NicuGal, MSN, RN]

All of our kiddos have to have one on, and there has to be one on when they come from L/D, except for micronates under 500gm. This is our hospital policy. For the micronates we put a piece of duoderm on the ankle and then the bracelet. Our bands have barcodes on them and they have to be scanned. We tried putting the bands on the inside of the bed, but it has to be on the kid. The rationale is that they can't speak and you can't ask them questions lol We got dinged by our health department when they came thru and the JCAHO surveyors (mock and real) have asked us if our patient has on a band. Plus we can't have any tape on any patient care surface, so we can't tape them in the bed either. We just put them on loose and replace when gross. Also, you have to have them banded, esp gainers and growers because in case of fire we have to stuff about 8 of them in this apron thing with pockets...that would be bad not to know who was who....

[karnicurnc, MSN, APRN, CNS]

We also strive to have 3 bands on at all times expect for the micro preemies. The birth bands are placed in plastic sleeves once they are cut off, either for an IV or because the baby grows. We use the Comfy Cuff system to secure the hospital band (with med rec #, med scan, etc) to the baby and those work very well. I highly recommend them.

[bmsrn]

Our unit does not use the ones from L & D at all. We can literally cut it off once the baby comes to the NICU. There is a universal ID band for our hospital. Ours get printed on a "baby" size and they are adjustable. Everyone gets one. Even the micro-preemies are supposed to have one on. The material is very thin, it's like a clear sticker that folds over the barcode and all the information on the tag. We can then wrap it around the babies ankle or wrist and adjust the tightness.

[NICU<3RN]

My hospital doesn't usually put any bands on the critical babies in the ICU, the bands are usually in the bed with the infant. In the step down area we have Hugs bands that are always on the babies (that beep/ set off alarm if someone takes the baby) and the other ID bands we try to keep on the babies on soft adjustable foam bracelets around their ankle or foot.

[Mimi2RN, ASN, RN]

We have to have at least one on the baby, the other can be taped to the bed. Those bands are frequently cut off for IV restarts, but can be repaired and replaced. The hospital arm band stays attached to the sheet that it prints on, and that gets taped to the bed. That's the one that gets scanned for meds and PCX checks. We only use Hugs tags on babies in Couplet Care who are outside of our locked unit.