Patient ID Bracelets in LTC?

Specialties Geriatric

Published

I am an RN and just started a job at an LTC center this past week as an ADON. My former job was in critical care.

QUICK QUESTION: I was extremely surprised to find that not a single patient had any type of ID bracelet or name badge. I was hanging an IV for an LPN and was looking for a bracelet. I did not know the patient, the patient was confused, and I had no way to identify the patient other than the name on the door. My immediate thought is that this is extremely dangerous. Or, am I out of line and this is a common thing in LTC?

Specializes in Gerontology, Med surg, Home Health.

We have pictures in the MAR and in the front of the charts. Most of the residents wouldn't keep a name band on for more than a day.

I've worked in LTC for 20 years and have never worked in a facility in which the residents wear namebands. It is their home! We have photos of each resident in the MAR and pictures of our wanderers in another book. When you work with the residents everyday you know their names, birthday's and diagnosis. You know their families too as well! There is no need for wristbands in LTC!

Specializes in Gerontology, Med surg, Home Health.

There is, however, a need to be able to identify each and every resident. Neither the DPH nor the Joint Commission surveyors would accept the answer "I know everyone here."

I worked LTC-I would but the ID band on -next day would find many of them on the desk-how the residents got them of is beyond me. Many times they would just disappear-we never knew what happened to the bands.

Could also cause skin issues.

Also would put bands on the wheelchairs-often questioned this-HIPPA..

Hard to get it right inLTC.

Bottom line is that the facility needs a way to id each resident. What way they choose is probably up to them, but the requirement is still the same.

Most poeple have posted already about the issues of keeping a arm band on or the dignity issue so that is why pics are done. Putting a name tag on a w/c isn't helpfull when the w/c get mixed up. Pics are usefull if they are updated regularly.

Specializes in Hospital Education Coordinator.

It may be their home, but the nurse is obligated to properly ID the patient before medicating or starting a procedure. What if a resident wanders to another room and lies on the bed? In comes the nurse and gives them a medication!

Specializes in LTC.

Where I work residents have armbands (although many often take them off) and there are pics in the MAR.

Specializes in Mental and Behavioral Health.
The inability to identify patients was one of the very reasons two days in LTC were enough for me. It scared me to death. Bless you all who work in LTC.

No, it's the gray-haired one with the glasses... NO! The other gray-haired one with the glasses...no.. NO! Not THAT one! :chuckle

Specializes in ER, Acute, home health, LTC, & Psy.

:grn:

Specializes in LTC.

"No, it's the gray-haired one with the glasses... NO! The other gray-haired one with the glasses...no.. NO! Not THAT one! :chuckle " In the wheelchair, right? LOL! It is scary when you first start at a LTC. Sooo many residents who all fit the same general description. To add to the confusion, and increased potential for med errors, my facility labels the beds "wrong". Bed 1 is by the window, bed 2 by the door. ??? I have been their awhile now, and still get confused over that one. Or maybe it's the other way around? I work nights which just adds to the confusion. In the pics on the MAR's, these people are up and smiling, have their hair done, (or ON), teeth in, glasses on, but at night, they are missing all of the above. People look very different in bed at night than they do up during the day. Fortunately, I know who all of my people are now. At first, I was as nervous as a cat in a room full of rocking chairs trying to do 0600 med pass. I have been terror-struck more than once thinking I had given the wrong meds to the wrong res. Even now I label my med cups so that I can check "one more time" to ensure the right person gets the right meds. (I take both res's meds in at the same time). I can't think of a good way to bracelet the residents without compromising privacy or causing skin issues. We do bracelet potential (ambulatory) elopers with a security device, otherwise we put in on their wheelchair. We also check them at least daily to ensure no skin issues emerge. If state came in and asked me how I know that that is the right person, I only really have one way to ID them: The pic in the MAR. We really can't use the name on the door to match to the corresponding bed...I don't think my answer, "I just know" would fly with them. Hmmmm. Food for thought, anyway.

Specializes in LTC, Rehab, Skilled Nursing, Management.

I can remember how it was the first time I worked in LTC and no one had a patient identifier on. It was difficult to know who was who.

Now, after having been in LTC for years, I can't imagine using arm bands. I agree that skin issues would arise. I already have seen this when using the Wander Guard bands around the ankles. I think the best way is with updated pics in the MARS and TARS. This is still difficult for the newcomer because when you are doing routine things, like passing trays in the dining room, or assisting a wandering resident to their room, you don't have the pic right in front of you. But, as people have already mentioned, this is home for these elders. And most facilities are in the middle of culture change and will continue to shy away from using institutional types of identifiers for residents.

I was wondering what is your facilities policy regarding this issue and how do they ID residents?

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