Pennsylvania association promotes standardized wristbands to prevent errors
Red, green, yellow, purple, and pink—these are the colors of one wristband color system improving patient safety in hospitals across the nation. But the key to success isn’t just the colors; it’s the fact that one particular color-coding system is catching on.
It’s common for hospitals to use an array of colors for patient wristbands as reminders for certain conditions, such as allergies or fall risks, but Bonnie Haluska, RN, CRRN, assistant vice president of inpatient services at Allied Services Rehabilitation Hospital in Scranton, PA, says having different color-coding methods in different hospitals puts patients’ lives at risk. The standardized color-coding program she helped create has been replicated in hospitals located in more than 20 states, and it was officially recognized by the Hospitals & Healthsystem Association of Pennsylvania in June.
Recognizing the problem
Haluska is chair of the Color of Safety Task Force, which was formed after the Pennsylvania Patient Safety Authority (PSA) received an incident report in 2005 that detailed a near-miss in which clinicians almost failed to resuscitate a patient who had been misidentified as do-not-resuscitate by a yellow wristband. The band was put on the patient by a nurse who often worked at another hospital where yellow signified a restricted extremity.
“Luckily, it was caught in time, but when [PSA] looked into it, they were horrified,” Haluska says. Hospitals across the state were using dozens of different colors to indicate a wide range of conditions.
“We are a rehab hospital, and we have satellite units in the acute care hospitals in our area. We realized that every single day, all our patients were put at risk because someone could unintentionally misread the intention of this color band,” Haluska says. She began calling local hospitals. Initially, about a dozen hospitals expressed interest, and the Color of Safety Task Force was created.
Creating the system
To avoid confusion, the hospitals agreed to give up their color systems and began researching the best uses for each color, using survey results from the PSA, adult education books, patient feedback, and colorblind physicians.
The group decided on a five-color system of embossed wristbands (see the flyer on p. 5 for more details). The committee sent out letters of explanation to members in the healthcare community, such as ambulance crews and dialysis and ambulatory centers.
“We had to train about 15,000 staff within the next two months,” Haluska says. “And everything went so smoothly, it was unbelievable.”
Although the policy did not meet much resistance, the task force did receive complaints about the red wristbands, which were embossed with the word “allergy” but did not specify what type. Haluska explains that the committee felt it best if staff members had to look at their charts for patient allergies, in case a wristband couldn’t convey all the necessary information. In contrast, she says, the pink wristbands, which indicate a restricted extremity, were a popular hit.
“Before [the bands], the patient would have a sign over the bed in the hospital,” Haluska says. “But if the patient was moved anywhere, the sign didn’t work.” Radiology and many other auxiliary units found the pink wristbands especially helpful.
Color of Safety Task Force hospitals now use colored labels on patient charts to serve as additional reminders. The committee has also just finished standardizing transfer records, which helps improve handoffs between hospitals.
“There’s a lot to be said about hospitals getting unified and working together on major projects,” Haluska says.