Code Status

i know some hospitals might feel that it would violate patient confidentiality, but our hospital's policy is that all patients who are a no code have a blue ID bracelet... all full codes have a red... so if you're not familiar with the patient and you walk into the room, you can quickly determine if they're a code or not just by looking at the bracelet...

ETA: we also have code status' posted behind the main nursing desk, on the patient's charts and on the daily worksheets we get at the beginning of shift...

beth

....all patients who are a no code have a blue ID bracelet... all full codes have a red... so if you're not familiar with the patient and you walk into the room, you can quickly determine if they're a code or not just by looking at the bracelet...

Thanks for the input, Beth. It's appreciated. As part of a "Code Idenitification Committee" at our hospital, I'm trying to gather ideas on how other facilities operate. Do you guys also use red armbands when a patient is Type/Screened for blood transfusions?

I'm also leaning towards the idea of armbands, but feel the patients are going to have an armfull of "bangles" by the time they are discharged. We use so many of them! ...armbands for patient identification upon entry to the ER, one for barcoded medication administration, one for being typed/screened/blood transfusion, one for allergies... I'm thinking if we can combine them on one armband, life would be simpler not only for the patient but for the nurses as well.

The quest continues....

We use blue armbands for DNR's. When the armband is placed on the pt, two licensed nurses must witness and sign in the nurses notes that it is the correct pt, etc. The code status is also posted in the room on the chart/flowsheet, the chart at the nsg station and we also write it in on our report sheets that most of us keep in our pocket. As for the multiple armbands, well, we take off the armband from the ER once they are admitted to our floor, and we don't have an armband for blood or allergies or barcodes. (We take the MAR sheet with the med we are giving into the room to do our checks, it has the allergies written on it.) The most armbands we ever have is three: if the pt is a "DNR" we have a blue, if they are a fall risk we have a yellow and then the regular white band that all patients have.

I'm thinking your best bet is to combine some of your info onto one armband.

Do you guys also use red armbands when a patient is Type/Screened for blood transfusions?

no, we use a clear yellow one for T&S's... but they're removed every 3 days when the T&S expires...

i can see that you would be hesitant to use an armband system when you already have so many... we basically have the ID bracelet (blue or red), orange allergy bracelet and a T&S (if necessary)... not so much to contend with...

beth

We also use armbands...and we have a big orange sheet in the chart that states code status (which is only occassionally filled out...but usually written somewhere else in the chart, they are new so we are still trying to get the docs to utilize them). We have green armbands for type/cross...our typical armband background color is blue (full code), we have other colors for no code and limited codes, etc. We have pink for lymphedema/mastectomys, etc if an am has a pink band on it, we know that means no venipuncture/BP/IVs in that side. Our monitor tech also as a "code" sticker up next to the patients that are no codes on her/his monitor.

We have pink for lymphedema/mastectomys, etc if an am has a pink band on it, we know that means no venipuncture/BP/IVs in that side.

Along the lines of armbands, I really wish our hospital would begin using those. Thanks for all the feedback, guys...It all helps.

Ahh...wouldn't life be somewhat easier if I could go back to the flowsheets at the bedside, but alas...this hospital is as paper-free as possible...no paper MARS, no flowsheets, no paper nursing notes, etc. (wait a minute...what AM I thinking!!!~~~I'd rather type my notes than write them!!!) Seriously though, the only thing on paper are the MD orders, everything else is computerized charting and computerized medication delivery (so-to-speak).

but it seems like that at our hospital, they, at least used to, put butterfly stickers above the bed plus have a purple arm band on the DNR patients. That way, as soon as you walk in the room, you know what their code status is. Just a suggestion.

Pam

We use blue armbands instead of white ones when a patient is a DNR.

we have a form that the doctor completes and the patient or family member sign, it is on bright orange paper and kept at the front of the patient notes.

Not sure if you are still looking for what other places do in their practice of noting code status. After the DNR order has been initiated by the doctor we put the blue armband on the patient, we write the patient`s last name up on a markerboard under the DNR section back in the back room of our nurses break area, we put a small blue sticker on the nursing treatment sheet, one outside the patient`s door, and one on the patient`s identification card that is kept at the nurses station. It has worked for us so far.

The "No Code" order is copied in front of the progress notes and MD orders.

The most effective way is report. The RN responsible for the patient gives report to the team. All LVN's, RT's, CNA's, and the clerk are told the status of the patient. We give report to the RN relieving us for meal and rest breaks and never have more than two patients in critical care. On the telemetry unit the charge nurse gives report to the monitor observer.

Whenever there is a deterioration in a patient the registered nurse responsible for that patient is there. Communication is everytihing.

I never let a patient die alone.

Much better now than in past years of unsafe staffing.