Sending patients home w/ an armband a HIPPA violation?

[Hawkinss]

Our admitting department raised this concern. Currently, we require that preadmit patients be armbanded with a hospital armband if pre-transfusion specimens are drawn. We then send the patient home with a warning to keep the armband on. We require that the patient present for surgery or outpatient infusion with the armband attached. If the armband is removed by the patient before admission, the pre-transfusion sample must be redrawn and testing repeated.

Since the patient's hospital armband has private information such as first and last names, DOB, account number, etc... is this a privacy issue? The argument is that the pre-surgical patient is going home, going to the store, eating out in public with the armband exposed and therefore others can see their private information. SO, they have proposed that they armband the patient, draw the pre-transfusion specimen, remove the armband and then "tape" it into the chart until the patient returns. I'm having some instinctive negative reaction to this proposal, but I can't really find any regulatory requirement that confirms the necessity of keeping the armband on the patient until transfusion. In fact, I can't really find any requirement that associates blood administration with an armband!

Thoughts?

Stephanie

[clmergen]

We send the patients home with their armbands and ask that they return with the armband, but I doubt many do. Upon admission, the patient is re-armbanded following a written policy. The same policy is used for patients that take off their own armbands while an inpatient or OR takes off a band. Since we don't use Transfusion Services specific armbands, we don't redo any work unless the new armband doesn't match the old armband.

[Bill]

It is the patient who discloses the information by showing the armband in public not the hospital (employees). To avoid any disclosure of information, the patient can wear long sleeve shirt/blouse or put tape over the writing to prevent anyone seeing the info.

[John C. Staley]

Time for a reality check.

Walk through your hospital and look at patients wearing armbands. How close do you have to get to be able to read any of the information on them? If some one is concerned about this they have too much spare time on their hands.

[skopti]

I agree with John. You have to be very close to the armband in order to read the information. Sometimes you need a magnifying glass to read those armbands....

[reidhospbb]

I will concur that you have to get very close to the armband to read any information. My older eyes need much larger type to be viewed. Once the patient leaves the premises with the armband on I feel it is their responsibility to maintain confidentiality.

[AMcCord]

I will concur that you have to get very close to the armband to read any information. My older eyes need much larger type to be viewed. Once the patient leaves the premises with the armband on I feel it is their responsibility to maintain confidentiality.

We've put a few on ankles at patient request - very hard to see their names in that location! We will replace the ankle band with an armband upon admission to make it easier for staff to find it.

[lgabbert]

Our hospital policy is the same as yours Stephanie. No one has ever questioned HIPPA violation.

[estiner]

We place an armband on the patient for the pre-transfusion sample to be drawn and then it is removed and placed on the chart - It it verified and reattached at the time of admission. No additional sample is drawn unless the current armband does not match the sample information. This system works very well for us. Previously when we would send the patient home with an armband, it would not come back or if it did, it was not readable for our POCT testing instruments.

[djtito]

Heck, the Dance Club I went to this weekend, sent me home with an armband, except it was hot pink.

[djtito]

Seriously, I think the armband is the patient's anyway and not someone else's, so it would only contain info

pertaining to that patient, no harm done.

[djtito]

We've put a few on ankles at patient request - very hard to see their names in that location! We will replace the ankle band with an armband upon admission to make it easier for staff to find it.

...at least its not on the big toe...

[bbbirder]

For our pre-op patients we take a photo ID and they sign a form attesting to no transfusions within 3 months. The band, photo ID and a copy of the form go to our OR and the nurse puts the band on the day of surgery. We have done this for many years.

We also use a similar system for our Heme/Onc patients who get drawn one day and come in the next for transfusion. Most of these don't object to wearing the band (they aren't going anywhere), but if they don't want to, we will do the photo ID and the outpatient transfusion nurse puts the band on.

Linda Frederick

[NedB]

We use a separate Arm Band for the Blood Bank. The band has a card with the Arm Band number embossed, from which copies of the number can be printed on demand. We allow the Patient to hand carry this back in and reattach on re-verifying the identification - with pictured ID, etc. This works for our serial Patients who come back in only for Platelets and Plasma Exchanges. We don't have to repeat blood work just to get an Arm Band number on the products. For crossmatches, naturally we start with a new Arm Band.