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Patient Alert Bracelet Standardization and Product Conversion March, 2017 Background Alert bracelets are utilized to provide a network wide standardized process of alerting caregivers and communicating special risk factors or patient needs. In 2004, Syracuse hospitals agreed on standardized alert bracelets among all hospitals - over time, this standardization has drifted. In 2008, the American Hospital Association established recommended standards for alert bracelets nation-wide to avoid potential patient safety events. In 2016, the Syracuse Quality Collaborative agreed to adopt the American Hospital Association recommended alert bracelets. In 2017, St. Joseph’s will adopt the American Hospital Association recommended alert bracelets and the new product conversion will take place on March 28th. Purple Alert Bracelet: Do Not Resuscitate Rationale for Alert Bracelet Old Bracelet New Bracelet Alerts the caregiver that the patient has a medical order NOT to be resuscitated. Purple Do Not Resuscitate Bracelet Application Procedure Change 1. If a patient has a medical order NOT to be resuscitated, write the patient’s medical record number and the last 3 digits of the electronic code status (DNR or DNR/DNI) order number on a label. 2. Attach the label to the purple DNR bracelet. 3. Prior to applying the DNR bracelet on the patient, the RN is to compare the medical record number on the DNR bracelet to the patient’s identification bracelet and confirm they match. Why? Patient safety is our number one priority. Over the past several years, there have been several occurrences where patients have received a DNR bracelet without a physician order to support application. While none of these resulted in actual patient harm, this is a near miss that could have resulted in a patient not being resuscitated. 4. Apply the Purple DNR bracelet to the same limb as that of the patient identification bracelet. 5. Document bracelet application in the Medical Record. Yellow Alert Bracelet: Falls Risk Rationale for Alert Bracelet Alerts the caregiver that the patient has fallen either prior to hospitalization or during the current hospitalization. Old Bracelet New Bracelet Additional Information Falls prevention supplies (Door Magnets and Slipper Socks) will be replaced with yellow products. This product conversion will be phased in over a 2-3 week time frame in which yellow and orange will be considered a high risk to fall. Pink Alert Bracelet: Limb Alert Rationale for Alert Bracelet Alerts the caregiver that this particular extremity should not be used for blood pressures, IV’s, venipunctures, injections or any other procedure which might compromise the extremity. Unless a specific medical order is obtained, the extremity is not to be used. Old Bracelet New Bracelet Indications for use -An invasive procedure i.e. cardiac catheterization or any interventional procedure using a brachial approach -Post-mastectomy -Post axillary surgery -Functioning arteriovenous shunt or fistula -Paralysis -Traumatized, diseased or compromised by vascular or neurological impairment -Recent surgery, cast or bulky dressing -PICC lines Bracelets and Associated Forms to be Eliminated Do Not Transfuse Bracelet (to be eliminated) Blood Refusal Release of Liability Form (to be eliminated) Radiation Safety Bracelet (to be eliminated) Patients are no longer required to sign the Blood Refusal Release of Liability form. The physician should still be notified if a patient refuses blood products, the no blood products order should be placed and the FYI flag should be placed in the electronic health record. Alert Bracelet Application and Removal • Application or removal of any alert bracelet will be performed by a registered nurse. • Whenever possible, apply the alert bracelet to the same limb as that of the patient identification bracelet • Whenever application or removal of an alert bracelet occurs, it must be documented in the medical record. • Should a bracelet be removed for any clinical reason, it must be immediately reapplied by an RN utilizing the verification process and documented in the medical record.