The Kentucky Hospital Association encourages members to use purple wristbands with the letters “DNR” to signal that a patient doesn’t want to be resuscitated.
The group’s vice president, Elizabeth Cobb, told the Lexington Herald-Leader that multiple hospitals have asked for guidance in recent months, so the campaign to encourage the use of wristbands will begin in March.
Cobb said she knew of no mistakes involving do-not-resuscitate orders in Kentucky hospitals.
The Kentucky Cabinet for Health and Family Services’ Office of Inspector General has issued seven citations for such mistakes since 2007.
Becky Babb, registration supervisor at Jackson Purchase Medical Center in Mayfield, said her hospital does not use the wristbands. Instead, the hospital notes a patient’s DNR on medical charts.
“A DNR must be completed when a patient signs into the hospital,” Babb said. “It’s only good for that one stay in the hospital. Items like a living will or a DNR are not applicable unless a patient is terminally ill or injured.”
James Wright, director of pastoral care at Western Baptist Hospital, said the hospital uses the wristband system to identify patients with DNRs.
“We’ve done the bracelet for about six or seven years and had no problems,” Wright said. “It’s a good system, but we have our chaplains follow up to make sure their wishes haven’t changed.”
Like Jackson Purchase, Lourdes also does not use DNR wristbands. Cindy Ford, palliative care coordinator at Lourdes, said if a patient requests a DNR, this wish is noted on the patient’s chart. Nursing staff alerts the relief shift about a patient’s wishes at a shift change. A DNR sticker is also placed on a patient’s chart. With hospital chaplains, she may visit a patient with a DNR to explain the order and ensure the request reflects a patient’s wishes.
“Normally, a patient’s reason for a DNR is because their quality of life as they know it has declined,” Ford said. “A patient may feel their quality of life has reached the point that they would enjoy no benefit if they were resuscitated.”
The Office of Inspector General does not order regulations, but issues best-practices bulletins saying nursing homes should offer a non-mandatory purple band to residents with DNR orders.
Contact Alan Reed, a Paducah Sun staff writer, at 270-575-8658.