Wristband Standardization: Enhancing Patient Safety in Healthcare Facilities

1. Wristband Standardization Project Joint Project Sponsors: Colorado Hospital Association (CHA) Colorado Foundation for Medical Care (CFMC)

2. Background • Wristbands meant to designate a certain medical condition should be consistent throughout healthcare facilities. • Certain colors become associated with certain medical conditions. • Multiple wristband colors in use for the same medical condition is a patient safety concern.

3. Background • Results from a survey of 57 Colorado hospitals showed: • 5 different wristband colors in use for both DNR and Allergy designation. • 6 different wristband colors in use for both Latex Allergy and Fall Risk designation

4. National Work on Wristband Standardization • Pennsylvania and Arizona were first states to implement wristband standardization. • Many other states, especially in southwest region, are currently working on similar projects.

5. Arizona and Pennsylvania Recommendations *Arizona is not currently recommending that all hospitals use Latex or Restricted Extremity bands, however they recommend the suggested colors if state hospitals prefer to use a separate band for these medical conditions.

6. Arizona and Pennsylvania Facts

7. Recommendations for Wristband Standardization in Colorado • Follow Arizona model • 10 other states, mostly in southwestern region, are also considering the Arizona model

8. Why Consider Regional Adoption? • Colorado receivesnurses most often from New Mexico and Oklahoma. • Colorado nurses are most likely to travel to Arizona and California. • We share borders and patients with states that are currently considering the recommended model.

9. ANSWERS TO FREQUENTLY ASKED QUESTIONS

10. DNR - Why not use blue? • Patient safety is about eliminating any potential for confusion • Code Blue = Resuscitate Patient • Blue Wristband = DO NOT Resuscitate • 73% of Colorado hospitals currently use Code Blue to alert medical staff of a COR

11. ANSWERS TO FREQUENTLY ASKED QUESTIONS

12. DNR - Why use Purple? • Purple is the most distinctive color option available • Orange too close in the color spectrum to red and yellow, which are currently being used to designate allergies and fall risk, respectively • Green currently being used to designate a latex allergy

13. DNR - If using the purple band, do we still need to look in the chart? • Yes. A chart should always be reviewed even if alert wristbands are used. • It is important to know the current status of an advanced directive so that a patient’s and/or family’s wish can be honored.

14. Allergies - Why use red? • Results of the hospitals surveyed showed that the majority of Colorado hospitals already use the color red.

15. Allergies - Do we write the allergies on the wristband too? • It is recommended that allergies be written in the medical record according to your hospital’s policy and procedure. • It is suggested that allergies not be written on the wristband for a couple of reasons including: • Legibility • Assumption that list is comprehensive and up-to-date

16. Fall Risk - Why did you select yellow? • Yellow has an association that implies “caution” • Caregivers would want to have knowledge to use caution with a patient who has a history of previous falls, dizziness, balance problems, weakness or confusion about their current surroundings.

17. Any barriers to implementation? • Both Arizona and Pennsylvania have noted little staff resistance. • Cost was not noted as a major barrier in either state • Education was not noted as a barrier • Both states provided hospitals with toolkits that contained educational materials

18. Additional Questions • Donna Kusuda Chair of Quality Professionals’ Group (CHA) HCA/HealthONE donna.kusuda@hcahealthcare.com • Crystal Berumen Colorado Hospital Association (CHA) crystal.berumen@cha.com • Cari Fouts Colorado Foundation for Medical Care (CFMC) cfouts@cfmc.org