The NoNo Sleeve: RNs take up arms to avert errors

By | 2020-04-15T16:41:14-04:00 June 27th, 2016|2 Comments

In 2010, Jill Drew’s father-in-law developed irreversible end-stage renal failure and elected to have an AV fistula placed for hemodialysis. The anxiety expressed by her father- and mother-in-law about protecting his fistula during hospitalization inspired the creation of the NoNo Sleeve. Despite placing tape on his arm and writing “do not use this arm,” they constantly had to remind healthcare providers not to use his at-risk arm. “This became particularly challenging when self-advocacy was not possible,” said Drew, RN, president, NoNo Sleeve, LLC. Not only was her father-in-law afraid to go to sleep, but her mother-in-law also refused to leave the bedside for fear an error would take place in her absence.

Like most, NoNo Sleeve started as a cottage business. It took about two-and-a-half years for Drew — joined by Kelly Reif, RN, vice president, NoNo Sleeve, LLC, in December of 2012 — to bring the idea to fruition.

They launched the patient safety tool in 2013, and in the end, they created exactly what they had hoped: a simple, effective and inexpensive product that would eliminate opportunities for medical errors to at-risk arms. The NoNo Sleeve serves as a visual barrier that clearly instructs providers and helps facilitate communication between nurses and patients, according to Drew. “It does the talking when patients can’t or when communication breakdown occurs between healthcare providers,” said Reif. “When you go into the patient’s room, you immediately know not to use that particular arm.”

Worth the effort

They’ve gotten discouraged over the years, especially when healthcare providers and organizations decided against using the NoNo Sleeve. “It is very frustrating when a healthcare organization forgoes patient safety, in most cases due to cost-saving initiatives or contracts with GPOs, otherwise known as Group Purchasing Organizations,” Drew said. “That said, we have learned that no can mean yes, yes can mean no and silence can mean anything.”

They have never gotten discouraged enough to want to give up. Testimonials from healthcare providers, patients and family members, saying thank you and sharing how the NoNo Sleeve helped, serves as a great motivation. In addition, they keep focused on all of their accomplishments along with their future goals. “Kelly and I have a great working relationship and our goals are aligned,” Drew said.

They’re also proud they’ve beaten the odds and made it through their first 18 months as entrepreneurs. “But it’s not just about the business,” Reif said. “It’s extremely important to believe in what you do and in the people you are doing it for.”

Their willingness to put in the time, remain patient and stay focused on the project has served them well, Reif said. They are focused on creating a new standard of care for protecting patients with at-risk arms. “We see this creation as our Trojan horse, as we continue to develop other new patient safety products,” Drew said.

Drew credits her ability to generate new ideas, network and make the dreaded cold calls as qualities that have helped her in this venture.

Reif has always been interested in business, new ideas and finding better ways of doing things. “There have been so many times over the years I would say, ‘They need to come up with this or that.’  Now we are the ‘they,’” she said. Reif credits her ability to work hard and never give up as qualities that have helped her in this venture.

Drew has been a nurse for 23 years and continues to practice part-time at the bedside, and said she’s always on the lookout for work-arounds. A nurse for 27 years, Reif works part-time, helping to manage the business side of nursing at a large hospital. Many of her responsibilities in that role complement her work with NoNo Sleeve, LLC.

Tips to keep in mind

The duo shared the following advice on creating a patient safety tool or starting a business.
• Watch for work-arounds because they are a sign of opportunity knocking.
• Hire a good intellectual property lawyer and accountant, or use accounting software to keep finances organized and accurate.
• Set up a website to help you build business.
• Don’t overspend, and maintain a cash cushion.
• Provide excellent customer service and follow-up.
• Don’t be afraid to fail.
• Use social media.
• Brand your business to define it to yourself, your team and your external audiences. •

Janice Petrella Lynch, MSN, RN, is nurse editor/nurse executive.

To comment, email [email protected]

For more information on creating a culture of safety, read the CE module, “What is Patient Safety? Creating a Culture of Collaboration in Healthcare.”


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About the Author:

Janice Petrella Lynch, MSN, RN
Janice Petrella Lynch, MSN, RN, is director of the Help & Resource Center at The Marfan Foundation. Also a nursing educator, she has held faculty positions at Wagner College, Skidmore College, Molloy College and Adelphi University. She is a member of the New York Organization of Nurse Leders and the Greater New York Nassau-Suffolk Organization of Nurse Executives.


  1. Avatar
    Maria July 7, 2016 at 4:55 pm - Reply

    Excellent idea, not just for while in hospital, but LTC and everyday. Never know when it maybe needed. Just like a med alert bracelet.

  2. Avatar
    Shirley Jacks May 4, 2020 at 12:57 pm - Reply

    Can I order a sleeve? I have one from a trip to the hospital . I have very thin skin and it is more comfortable than the regular protection sleeves.

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