Wristband Standardization Project

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Wristband Standardization Project

• Joint Project Sponsors
• Colorado Hospital Association (CHA)
• Colorado Foundation for Medical Care (CFMC)

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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.

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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

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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.

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Arizona and Pennsylvania Recommendations
Arizona Pennsylvania
DNR Purple Blue
Allergies Red Red
Fall Risk Yellow Yellow
Latex Green Green
Restricted Extremity Pink Pink
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.
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Arizona and Pennsylvania Facts
Arizona Pennsylvania
Number of hospitals in the state adopting the standardization model 100 hospital commitment from CEOs 11 hospitals
Mandated through state legislature No No
Other states moving forward with same color adoption New Mexico Utah Nevada California Wyoming Oregon Washington Montana Oklahoma West Virginia None at this time
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Recommendations for Wristband Standardization in
Colorado

• Follow Arizona model
• 10 other states, mostly in southwestern region,
  are also considering the Arizona model

Allergy RED
DNR PURPLE
Fall Risk YELLOW
Latex Allergy GREEN
Restricted Extremity PINK
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Why Consider Regional Adoption?

• Colorado receives nurses 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.

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• ANSWERS TO FREQUENTLY ASKED QUESTIONS

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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

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• ANSWERS TO FREQUENTLY ASKED QUESTIONS

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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

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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 patients and/or
  familys 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.

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Allergies - Do we write the allergies on the
wristband too?

• It is recommended that allergies be written in
  the medical record according to your hospitals
  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

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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.

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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

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Additional Questions

• Donna Kusuda
• Chair of Quality Professionals Group (CHA)
• HCA/HealthONE
• donna.kusuda_at_hcahealthcare.com
• Crystal Berumen
• Colorado Hospital Association (CHA)
• crystal.berumen_at_cha.com
• Cari Fouts
• Colorado Foundation for Medical Care (CFMC)
• cfouts_at_cfmc.org