Patient misidentification is often the root cause of many hospital errors. Incidents like operating on the wrong body part or administering an incorrect medication are scenarios that seem unimaginable. Unfortunately, they happen much too often. Fortunately, safety measures like color-coded patient wristbands help prevent these mistakes from happening. They are not fool-proof. Humans still make human errors, but the goal is to reduce the risk as much as possible.
The incidents mentioned above have led to the creation of safeguards that support health professionals and keep patients safe. “Time-out sessions” in operating rooms mean taking a literal pause to review the correct procedure, patient, and location. Barcode scanning prevents a patient from receiving a wrong or dangerous medication they may be allergic to.
Standardized patient wristbands are another initiative to help ensure consistency and communication. Hospitals and healthcare organizations have taken it upon themselves to research and survey the use of wristbands in their facilities. After comparing this information with other states the organizations can produce a recommendation for standardized wristband color-coding. The goal is for all hospitals nationwide to use the same color-coded alert wristbands. This action, along with strategies to improve recognition, help prevent confusion.
Did you Know?
The Caresfield team recently helped a 6,000+ bed health system to achieve robust wristband standardization. We also supported a 700+ bed hospital to cut costs, standardize their inventory, and increase patient comfort with a Tyvek alert band offering.
Request a standardization review for your admissions wristbands.
Safety Challenges and Importance of Wristband Standardization
Like most calls for change, the need for wristband standardization occurred after a “near-miss” incident. A patient in Pennsylvania received a yellow wristband that meant “do not resuscitate” in this specific facility. The nurse caring for the patient believed it to mean “limb restriction” from her role at another hospital. As fate would have it, the patient coded. If other quick-thinking staff had not identified the error, this patient may not have received the life-saving measures he needed.
Not using standardized wristbands across hospital systems and nationwide creates an opportunity for these mistakes to occur. The challenge lies in several different areas. First, implementing any change takes time and resources. If staff likes things a certain way and there can be pushback. New policies take time to write, and there is a learning curve that requires education and support during the transition. Staff must ensure patients receive the correct wristbands immediately upon admission. They should also be reassessed throughout their hospital stay. Another challenge is patients or families refusing wristbands. In this instance, clinicians must educate regarding the reason for the wristbands and document accordingly.
Types of Alert Wristbands
At this point, let’s first take a look at the most common types of wristbands found in inpatient settings.
A Call For Standardization
UPDATE: Since we first published this article, the FDA has released a statement regarding the exclusive use of device identification patient bracelets or wristbands to “encourage following AHA recommendations and reserve the use of purple bracelets or wristbands only for DNR status.” (The FDA’s statement only reinforces what is already described in this article concerning the need for standardization, and purple bracelets or wristbands being used only for DNR status.)
See:
http://repertoiremag.com/fda-urges-manufacturers-to-follow-aha-standard-colors-and-use-purple-bracelets-wristbands-only-for-dnr-status.html
https://www.fda.gov/medical-devices/industry-medical-devices/use-purple-bracelets-or-wristbands-only-do-not-resuscitate-status-letter-industry
Due to the incident mentioned earlier, the Pennsylvania Patient Safety Authority took the initiative towards color-coded wristband standardization. In 2008, the American Hospital Association (AHA) requested that all US hospitals standardize color-coded patient wristbands to ensure safer care practices. The AHA recommends the adoption of the following three wristband colors and meanings:
Most facilities use white wristbands exclusively as the patient-identifying wristband. This includes their name, date of birth, medical record number, and date of admission. Facilities that use a barcode scanning system for medication administration will find this barcode on the white patient wristband. Pink usually signifies a limb restriction. Meanwhile, green identifies a latex allergy in some facilities.
While a work in progress, more than 30 states have adopted standardized color-coded patient wristband colors. Some states and facilities, such as the Wisconsin Hospital Association, have identified and adopted additional color-coded bands to assist with patient identification. They use a gray “multiple victim” wristband when a patient is part of an incident involving five or more victims. This allows for better tracking and assists with family reunification.
In addition to these color standardizations, the AHA recommends several other strategies to reduce errors.
- Place the alert wristband on the same arm as the patient identifier bracelet. (except in the instance of a limb alert, in which case that wristband should be on the limb needing restriction).
- Pre-print wristbands with bold, clear text. Do not write on the wristbands.
- Do not remove wristbands at discharge. Keep wristbands on through transfers and only take them off once the patient has returned home.
Strategies Implemented From Hospitals Across the US
Many hospitals and safety groups have created their own “toolkits” and urge other hospitals to mimic their models to promote standardized protocols across all healthcare systems. They share the following safety measures:
- First, It’s easy to confuse social cause bracelets such as the yellow “Livestrong” bracelet with certain hospital alert wristbands. Remove the bracelets to prevent errors.
- When admitting a patient from another facility or nursing home, remove any previous wristbands. These patients should receive new wristbands upon admission. Not all facilities may follow the same color-coding guidelines, so implementing a protocol to apply new wristbands is best practice.
- Utilizing the same color-coding for all stickers and signage cuts down on confusion and prevents mistakes. For example, if a patient has a pink limb restriction band on their right arm, consider placing a pink sign above the right side of the hospital bed as another added alert.
- Educating patients and family members on the use and meaning of the bands helps them understand the importance. They can act as another safeguard to prevent clinicians from making mistakes.
- Staff should also receive training on any new color-coded patient wristband systems. This should include anyone who interacts with patients such as nurses, laboratory staff, dietary staff, therapy services and more.
The standardization of color-coded patient wristbands is undeniably an effective, inexpensive, and simple way to communicate important patient information. Utilizing the same colors across all facilities and incorporating the strategies outlined here prevents unnecessary and potentially dangerous mistakes from occurring.
Caresfield offers color-coded patient wristbands that meet the guidelines set by the AHA and state standards. Alert wristbands are pre-labeled with large, dark text to ensure clarity. Wristbands are available in Tyvek or plastic materials with multiple closure options for a secure, tamper-proof fit.
Request a standardization review for your admissions wristbands.
Just fill out the form below, and one of our Caresfield Wristband Technicians will be in touch with you ASAP to begin your conversion process!
Maegan Wagner, BSN RN CCM has over 10 years of healthcare experience. Her nursing career has led her through many different specialties. Her passion lies in educating through writing for other healthcare professionals and the general public.
