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Hospital wristband color standardization

Health Factors: Quality of Care
Decision Makers: Healthcare Professionals & Advocates
Evidence Rating: Expert Opinion
Population Reach: 10-19% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Many hospitals put colored wristbands on patients to alert health care providers about specific patient conditions such as allergies or elevated fall risk (Wood 2011). In states without a standard color scheme, hospitals choose a variety of schemes, which can lead to confusion for health care providers who work with multiple hospitals (Sehgal 2007).

Expected Beneficial Outcomes

Improved patient safety

Evidence of Effectiveness

Standardizing hospital wristband colors is a suggested strategy to improve patient safety (AHA-Wristbands 2008, Sehgal 2007). Anecdotal reports suggest that provider confusion decreases and patient safety increases following standardization (AHRQ HCIE-Severson, AHRQ HCIE-PA wristband).

When rolling out a standardized system, experts suggest training health care professionals broadly, designing a methodical roll-out plan, and addressing the concerns of bedside nurses (AHRQ HCIE-Severson). Hospitals may also consider supplementing wristbands with additional cues. Wristbands can be difficult to discern at a distance, in low light, or when obscured, and can also go unnoticed during a crisis. Warnings on doors or treatment tools, or highly visible cues on hospital clothing may be more noticeable than wristbands in some situations (Wood 2011).

Hospitals may need additional bands to comply with state standards. In Pennsylvania, wristbands cost about $40 per 1000 bands (AHRQ HCIE-PA wristband).

Implementation

United States

A majority of states recommend that their hospitals use red wristbands to signify patient allergy, yellow for fall risk, purple for do not resuscitate. Some states also use pink to warn of a restricted extremity or green to signify a latex allergy (AHRQ-Wristband).

Wisconsin

The Wisconsin Hospital Association (WHA) set Wisconsin’s voluntary standard color scheme. Red means allergy, yellow means fall risk, and purple means do not resuscitate (WHA-WI).

Implementation Resources

St. John 2009 - St. John Companies. Color-coded wristband standardization in Louisiana: Implementation tool kit. 2009. Accessed on March 20, 2017

Citations - Description

Sehgal 2007* - Sehgal NL, Wachter RM. Identification of inpatient DNR status: A safety hazard begging for standardization. Journal of Hospital Medicine. 2007;2(6):366–71. Accessed on March 20, 2017
Wood 2011* - Wood SD, Bagian JP. A cognitive analysis of color-coded wristband use in health care. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. 2011;55(1):281–5. Accessed on March 20, 2017

Citations - Evidence

AHA-Wristbands 2008 - American Hospital Association (AHA). FDA quality advisory on implementing standardized colors for patient alert wristbands. Washington, DC: American Hospital Association (AHA); 2008. Accessed on March 20, 2017
AHRQ HCIE-PA wristband - Agency for Healthcare Research and Quality (AHRQ). Consortium of Pennsylvania hospitals adopts standardized wristband colors, leading to reduction in falls, allergic reactions at rehabilitation hospital. Rockville: AHRQ Health Care Innovations Exchange. Accessed on March 20, 2017
AHRQ HCIE-Severson - Severson S. Statewide standards for color-coded wristbands are adopted by vast majority of Arizona hospitals. Rockville: AHRQ Health Care Innovations Exchange. Accessed on March 20, 2017
Sehgal 2007* - Sehgal NL, Wachter RM. Identification of inpatient DNR status: A safety hazard begging for standardization. Journal of Hospital Medicine. 2007;2(6):366–71. Accessed on March 20, 2017
Wood 2011* - Wood SD, Bagian JP. A cognitive analysis of color-coded wristband use in health care. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. 2011;55(1):281–5. Accessed on March 20, 2017

Citations - Implementation

AHRQ-Wristband - Agency for Healthcare Research and Quality (AHRQ). Standardized color-coded patient wristband. Toolkit and implementation resources. Accessed on December 9, 2015
WHA-WI - Wisconsin Hospital Association (WHA). The color of safety: Standardization and implementation manual. Madison: Wisconsin Hospital Association (WHA). Accessed on March 20, 2017

Page Last Updated

February 2, 2014

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