How do they post DNR in the patients rooms at your LTC

[dinkymouse]

Everywhere I have worked there is a place in the room where it states DNR. This facility posts a heart if they are a code. I would much prefer knowing a patient is a dnr without having to look for where ever the heart might be. Maybe if the hearts were all in the same place would help.

Also is there a specific spot in your facility where new orders are put?

[cindyjean]

Due to the fact that patients get moved to new rooms( and errors are made in getting everything moved) , & plus they are not always in their rooms...we use nothing to indicate code status that is visible in the patient room ..or on the outside fo a chart. we have an * by their name on the daily report sheet we use in report each shift and any change in code status is reported as well.On the very front of the chart is the orange sheet that states their code status and also living will, POA etc... also on the top of each med cart of each unit, is a list of names with the *. we only have 9 people that are full codes out of 70.

[Annabell43]

In our facility, we use red armbands for DNRs and white armbands for full codes. This seems to work very well. Every time we renew the order for the code status the armbands are rechecked. :)

[1983sunshine]

we use the dot system... red for dnr, yellow for restricted code, and green for full code. dot is placed on binder of chart, on the careplan, and on the index card at the bedside (pts name on card also).. in addition, armbands are coded.

[CapeCodMermaid, RN]

we use the dot system... red for dnr, yellow for restricted code, and green for full code. dot is placed on binder of chart, on the careplan, and on the index card at the bedside (pts name on card also).. in addition, armbands are coded.

Could you please explain "restricted code". We have either DNR or Full Code. Isn't a restricted code like doing a "little" CPR???

[donmomofnine]

at facility where i work part time it is considered a hippa violation to have anything that can be viewed by any visitor or non nursing personnel..nurse who takes report can pass status to support team

ltc

I think that it's not a problem when outsiders wouldn't know the signifigance of the symbol.

[Jedi_Iatros]

We don't. It's a HIPAA thing. We're supposed to know who's full code and who's DNR/C&C by heart. Otherwise, we have forms in our resident's chart and in our report sheets.

[vloho]

When I first moved into LTC 20 yrs ago,"They" were just removing armbands, so we don't even have that. Usually a red or green dot on the spine of the chart or the facesheet

[TBLPN, LPN]

"Full Codes" are an issue in the LTC facility that I work in, unfortunately. I have more full codes, many more, than DNR. This facility that I work in is brand new, it's only been open a year. A lot of bugs to work out of the system, believe me. Its really nerve racking. I am the charge nurse on night shift. I have in the short year that we have been open have had 2 full codes...........unbelieveable. However, this facility is very naive about a lot of things, and it was "against HIPPA regulations" I was told to put 'dot's' or color code the name tags on the charts (seemed crazy to me since the patients name, doctor and room number was in full view for all to see) We have to look inside the chart, and hopefully medical records has done their job and put the DNR/FULL sticker in there, which more often than not they havent. So then I have to search under the advanced directives, and again, hope that it is there. The first full code I had at this facility, it's pretty interesting, I had the other nurse check the chart, no sticker/no advanced directive sheet signed. hmmm, bad day for me, I knew she was a code, but wanted the other nurse to check while I'm getting the crash cart, wanted to be SURE, come to find out, in the middle of the code, a CNA comes down to the room tells me my DON is on the phone and needs to talk to me, I (as politely as I could) told her to tell the DON I was a little busy, the CNA says NO she says stop coding her, the family signed the DNR paper yesterday, it's in the chart "somewhere"........hmmmmmmmmmm. This nurse, not the happy camper, to say the least. The paper had been signed, and was put in the back of the chart, no one except the DON and Administrator new it was there.......It is top priority for me now to KNOW who are my FULL CODES. I don't trust my management team with that anymore.

[tatgirl]

In the facility I work at if a pt is a DNR there is a red circle sticker on the spine of the chart. There is nothing posted in the rooms. Of course in the event of a code blue if we didnt know or not, someone would have to run to look at the chart...... I like the idea of the wrist bands having a colored dot on them, I will bring this up to our DON when I go into work.

Wendy

[Daytonite, BSN, RN]

Just thought I'd mention that in the Medication Errors regular feature of the current June issue of Nursing 2006 is a short article about problems that have been encountered with color-coded patient bracelets. Part of the article says "A survey by the Pennsylvania Patient Safety Authority found that four out of five hospitals, surgery centers, and birthing centers use color-coded wristbands to signal important medical information about patients, but the significance of the colors varied from one facility to the next. Compounding the confusion is the fact that only one-third of the facilities require people who are wearing colored wristbands to remove them at the time of admission." Something that really caught my attention in the article was an incident they cited where one hospital used yellow wristbands to indicate no blood draws were to be done from that extremity of a patient and a new nurse working at the hospital mistook it to mean that patient was a NO CODE since this was the meaning of a yellow wristband at the facility she had previously worked. Patient ended up coding. It had never occurred to me that facilities used so many different colored wristbands and for so many different things! This article is on page 14 of the current issue if you're interested in reading it.

[st4wb3rr33sh0rtc4k3]

It is difficult when they are only listed in the charts.

One time I had a patient become unresponsive and unconscious. I had to run down to the nurses station, find the chart, and then find out she was DNR. Weewwww... She ended up being fine after that, she vomited and she said, "Here I am!"

Well, another thing is we try to communicate any changes in status at report, but as you know things can be miscommunicated.

[cathy54]

Good Morning.

This is a curious question. When I was in school, I remember the instructors that a card or some such would be in the room (above the bed). The last place I worked (I am taking some time off to breath), had no cards in the room, the residents had no arm band, the charts were not coded on the outside ( patient confidentiality). and no sticker on the inside of the chart. You had to look for the DNR paper SOMEWHERE in the front of the chart.

I never gave it much thought until today. The next place I work, I will ask questions.