Is this Safe? Census: 45 / ID Bands: 0 / # of Nurses: 1

[carriebarton59]

Is this Safe? Census: 45 ID Bands: 0 Nurses: 1

I started a Per Diem RN position and was surprised to learn that none of the patients wear ID Bands. The accepted method of patient identification for medication administration is (1) a Photograph from the Med Pass Book (no computers here) or (2) to "ask the aides" who is who.

The most prevalent diagnosis in this population is dimentia and many patients cannot tell you their own names. So I'm wandering through the dining room with a photo in one hand and medication in the other. Or, after dinner, I'm trying to identify patients as they wander through the hallways. The Med Pass typically takes the seasoned nurses on this floor from 6 to 7 hours.

When I asked why the patients wear no ID Bands I was told that it had nothing to do with HIPPA but rather, it is a matter of "Patient Dignity" and that the bands get wet in the shower.

Eventually I will get to know all the patients but in the meantime, is this safe? And, is it standard practice?

[litbitblack, ASN, RN]

I work long term care and none of mine where them either. took a little bit of time to get used to it. I asked the aides and looked at the pics. its gets better once u get to know them

[canigraduate]

In my former LTC facility, everyone had plastic-coated ID bands on their wrists. Except for people who had been there forever and were bedbound - their bands were attached to the bed.

I personally think your facility's method is unsafe. Photographs are a snapshot in time, and people's faces change, sometimes quickly. Relying on aides is a good backup, but what if there are new aides on at the same time as there are new nurses?

I would research different ID options and present them to your management, if I were you.

[classicdame, MSN, EdD]

there are waterproof bands available and not expensive.

If you have the patient's picture ID and I need it what do I do???

[wooh, BSN, RN]

Long term care, it's the patients' home. Not a hospital. Do you wear an ID band at home? You really do get to know who everybody is pretty quickly. I understand that it goes against everything we're taught, but if there's one thing a nurse needs, it's flexibility.

I do remember when I worked long term care, there was a new nurse that desperately wanted to go with making the resident tell her their name. She tried it with a woman who'd been married MANY times and ended up giving her 4 different last names before the aide told her she never ever ever remembers her current last name. :)

[TheCommuter, BSN, RN]

I started a Per Diem RN position and was surprised to learn that none of the patients wear ID Bands.

The people who receive care at nursing homes and dementia units are residents, not patients, because they live at the facility. The long term care facility is their home. It is the place where they reside.

I've worked at several nursing homes and none of the residents wore ID bands because people do not usually wear ID bracelets inside their own homes. Once you get to know the residents, the lack of ID bands tends to pose no problems.

[JSBoston]

I agree about a nursing home being a resident's HOME, and people do not wear name-bands in their HOME... BUT...

If I were going to be a confused person living with 50 other confused old people, and I was depending on someone I didn't know to give me cardiac meds, insulin etc... I sure wouldn't mind wearing a small name band for my safety. If I were to put my dad in a place like that, I'd make him is own name band even if he was the only one to do so. Sometimes pt safety trumps the irritation of wearing a name band.

[TheCommuter, BSN, RN]

Sometimes pt safety trumps the irritation of wearing a name band.

Many state surveyors will issue a deficiency (tag) during a full book Medicare/Medicaid survey to a facility where residents are seen wearing identification bands due to issues that revolve around dignity and privacy.

[TDCHIM]

From a pure risk management position, it sounds like trouble, particularly during times of high staff turnover. I do understand the perspective of "resident versus patient," but I can already hear family members screaming bloody murder if a new employee unwittingly precipitates a serious adverse event after giving someone incorrect medication due to an out of date photo.

I know when I was in college, my school had everyone wear or carry ID cards on lanyards after several on-campus security issues. It was a somewhat similar setting, in that the dorm was my residence. It isn't always ideal, I grant you, but safety issues seem pretty important in an LTC facility where medication mixups are a serious danger. Maybe in a few years people will be able to use things like portable retinal scanners....

[JSBoston]

It's been a long time since my LTC days, but I remember everyone having a name-band. I just can picture the problems that can occur from not putting one on a confused patient. It just seems scary to me. There really should be something other than a picture and depending on aides to identify someone. Maybe a very small plastic numbered band and the number would match the MAR... besides... really how many people do you have to worry about with privacy and name-bands? Who is in contact with the resident? Nurses, aides, family... housekeeping? Yes it's not an ideal situation... but I'd prefer to deal with the complaints of a wrist band than risk giving an incorrect med. I wonder how often the photo albums are updated?

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Tried LTC for exaactly 2 shifts. Don't remember how many patients there were, all the pics in the MAR's were of little old white haired people in a rocking chair. Couldn't tell one from another. I quit and moved to another town to work.

[oramar]

I have heard that "this is their home, do you wear name bands in your home" reasoning for the no name band policy. It struck me that it was made up by a bunch of desk jockeys that have no idea that they are putting patients in danger. It is one of the reasons I also worked for a week in LTC and then fled.