How Code Purple Came to Be Code Purple

How Code Purple Came to Be. . .

Code Purple Is the hospitals standardized response when an adult patient is reported missing, is not competent or a physician deems them medically unsafe to leave.

Objectives At the completion of this section you will be able to: • Determine whether a patient is at risk for wandering or elopement. • Consider and implement (as appropriate) interventions to reduce the risk of elopement. • Take next steps to activate a Code Purple when an adult patient is discovered missing. • Caregivers (All Staff) responsibilities for assisting in Code Purple response.

“Oh No! Where is my patient? ” Evolution of Procedures Over Time • • “ 30 seconds to Media” Issaquah Urinal (capacity) Ballard ARS (crossing county lines) California (patient found in stairwell)

Risk Factors Things to consider when evaluating a patient for an elopement risk. • Is there a known risk for wandering or elopement (e. g. , gave verbal indication, made prior attempts)? • Does the patient have capacity to decide to leave against medical advice (ability to understand the affects of his/her decisions)? • Is the patient in danger of harming him/herself or others? • Is there a current medical hold on the patient?

Interventions to Reduce the Risk of Elopement • Place patient close to the nursing station. • Remove the patient’s clothes and shoes from the room (so patient won’t be tempted to dress and leave). • Alert all staff on unit to remain aware of the patient’s location. • Put the patient in a purple gown obtained via the linen department for ease of visibility. Purple gowns can be ordered through central supply. • Consider taking a picture of the patient for identification. (Ask for assistance from Security Services if camera is needed. ) • Remember a Code Gray may turn into your next Code Purple.

How to Activate a (possible) Code Purple ( Dial 3000 for First Hill, Cherry Hill, Ballard, Issaquah, and ACC’s ( Dial 5911 for Edmonds • • • Announce possible Code Purple Give your name Provide specific location (campus, floor and room # or address) q The Administrative Nursing Supervisor, Security Services, and the Safety Team will respond to help staff evaluate the situation and take appropriate actions.

Response Assessments • Evaluating Risk Factors – Known risk for wandering/elopement – Capacity to leave AMA – Danger of harm – Medical Hold • How long has patient been gone? • Is the patient a smoker/drug use? • Visitors come? • Picture/description – Video surveillance

Additional Code Purple Responses • Upon hearing Code Purple paged overhead, all staff reviews the information on the Swedish Online home page or via 386 -NEWS, searches their immediate department area for the missing patient, and continues to remain alert until the Code Purple is cleared by overhead page. • Normal Intranet Online View: • View once Code Purple Activated:

Additional Code Purple Responses • If the patient is located, call ext. 3000 and attempt to maintain visual contact with the patient. • A search of public areas within the hospital is divided among available staff such as Environmental Services, Engineering, and Central Dispatch & Transport/ Transportation staff.

If Patient is Found • • Mitigate!! Purple gown/take the clothes Get a photo Place by nursing station Obtain a “sitter” Security/unit awareness of risk for elopement FYI Note in electronic medical record Medical intervention (e. g. , medications, electrolytes, restraints? ) • Attend to patient’s health and mental status • Service Recovery for patient/family • Contact with patient (healthcare agreement)

Moment of Truth • • • Patient is NOT found Patient is on medical hold Patient is threat to self/others Patient does not have CAPACITY to leave AMA YOU MUST FIND THE PATIENT!!! Yes, and you’ll be the media spokesperson!

External Notification • Alert Administrator On-Call/Senior Leadership • Alert Risk Management/Legal • Call 911 – Public Transit – Taxis • Alert Public Information Officer (PIO) – Script ready for the media – Spokesperson – Imploring public’s assistance • Assign Family Contact • Contact EAP

List of useful hyperlinks • • • Missing Adult Patient: Code Purple Flow Chart Code Purple Checklist Leaving Against Medical Advice Healthcare Agreement HCA Sample

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