What to do when patient refuses wearing a name band?

[pinkdoves, BSN]

Sorry for posting so much I just have a lot on my mind. This is a question I think of a lot and no ones seems to know the answer to. I work with children, and there are some (whether bc of psych issues, autism, etc) children who refuse to wear the bracelet. Some of them even rip it up. So what we do is leave the patient name band by the computer. Obviously regulations and the law require all patients to wear this. But what are we supposed to do when they refuse? When inspectors come by and yell that so and so is not wearing a patient name band??

[SmilingBluEyes]

Chart chart chart. I used to attach said name bands  ( I always had at least two) to their chart and bed rails back in the day. Don't let the state see you doing that however.

Maybe a peds nurse can chime in? I am sure they run into this all the time.

[Wuzzie]

Patient label on double-backed tape with Tegaderm over it on their back or whatever body part they tolerate it on. 

[mmc51264, BSN, MSN, RN]

put it on their foot. We had some lazy night shift nurses that put the bands by the computer keyboard and with the higher pt turnover we have, there were times when the wrong pt's nameband was there. 

We have a zero tolerance policy. Lab has to scan. We have to scan every med. We are tracked for that. 

[pinkdoves, BSN]

11 minutes ago, Wuzzie said:

Patient label on double-backed tape with Tegaderm over it on their back or whatever body part they tolerate it on. 

but wouldn't they see you doing that? I already know some patient's I've worked with would not tolerate that at all

10 minutes ago, mmc51264 said:

put it on their foot. We had some lazy night shift nurses that put the bands by the computer keyboard and with the higher pt turnover we have, there were times when the wrong pt's nameband was there. 

We have a zero tolerance policy. Lab has to scan. We have to scan every med. We are tracked for that. 

you mean like on their ankle? that's how we usually put it on for toddlers/babies without issue. some kids wouldn't let you do that though

16 minutes ago, SmilingBluEyes said:

Chart chart chart. I used to attach said name bands  ( I always had at least two) to their chart and bed rails back in the day. Don't let the state see you doing that however.

Maybe a peds nurse can chime in? I am sure they run into this all the time.

I've been working at this children's hospital for 1 1/2 years and I've always seen people just put it by the computer. it just doesn't seem like correct protocol though and I'm afraid to ask the nursing supervisors for fear they will yell at me 

[Wuzzie]

4 minutes ago, pinkdoves said:

but wouldn't they see you doing that? I already know some patient's I've worked with would not tolerate that at all

I’ve never really experienced a kid that didn’t tolerate it. Plus if you put it in a place they can’t reach/can’t see it shouldn’t be an issue. I guess you could wait until they were asleep to apply it. All I can say is what you guys are doing is no bueno. 

[pinkdoves, BSN]

3 minutes ago, Wuzzie said:

I’ve never really experienced a kid that didn’t tolerate it. Plus if you put it in a place they can’t reach/can’t see it shouldn’t be an issue. I guess you could wait until they were asleep to apply it. All I can say is what you guys are doing is no bueno. 

but what happens when they take a shower or something? are you putting it directly on their skin or their clothes? 

[Wuzzie]

You take a piece of adhesive tape and double it on itself with the sticky sides together. You can either stamp it if you have the old-fashioned patient plates and stamper or stick a patient label to the tape. Lay that on their skin and put a Tegaderm over it.  The Tegaderm provides reasonable water protection or just put a new one on after a shower. Even having to do that is better than having no ID at all. That’s a recipe for disaster. 

[pinkdoves, BSN]

1 minute ago, Wuzzie said:

You take a piece of adhesive tape and double it on itself with the sticky sides together. You can either stamp it if you have the old-fashioned patient plates and stamper or stick a patient label to the tape. Lay that on their skin and put a Tegaderm over it.  The Tegaderm provides reasonable water protection or just put a new one on after a shower. Even having to do that is better than having no ID at all. That’s a recipe for disaster. 

ohhhh I see what you mean now. that's so clever. I have never seen that being done in my life...you know what I'm doing tomorrow LOL

[FolksBtrippin, BSN, RN]

It happens in psych. We document that the patient refused a bracelet and we use name and birthdate to identify. Some nurses put the bracelet by the computer but IMO this is unsafe and not okay. 

[amoLucia]

I don't like loose bracelets floating around. Honestly - had a LTC pt put on another's bracelet. It was the lab tech who recognized the pt wearing the wrong ID and let me know. As a floating supervisor, I wouldn't have known that LOL from Florence Nightingale, but the tech did. (TY God!)

What scared me was if there had been any previous misidentification by others, but MOST seriously, was my census correct?!?!?!

Each unit did an immediate bracelet identification check that night before we all went home.

But OP did ask, what else could be done .... While I still worked before retirement in LTC, we had pt pix avail. But always had to hope they were clear & up-to-date pix. Some of those MAR photos looked liked pts being 'laid out'. Don't know how it would work with pyxis/computers.

[Emergent, RN]

They have human rights, F the regulators. If they refuse to be a barcoded commodity, chart about it and tape it to the foot of the bed.