RMH standardizes use of wristbands to protect patients

Imagine this scenario: Hospital workers almost fail to rescue a patient who had a cardiopulmonary arrest because the patient had been incorrectly designated as DNR (do-not-resuscitate).

The source of confusion was a yellow wristband placed on the patient by a nurse. In that hospital, a yellow wristband meant DNR. In a nearby hospital where the nurse also worked, yellow was used to indicate "restricted extremity," meaning that the arm is not to be used for drawing blood or for an IV line.

Fortunately, another nurse recognized the mistake, and the patient was resuscitated.

This "near miss"—which occurred in Pennsylvania in late 2005 and sparked a national discussion about how to prevent such errors—highlights why Richards Memorial Hospital is joining other Texas hospitals to implement a voluntary standardized color-coded wristband patient safety initiative.

The move in Texas to have all hospitals standardize to the same colors was initiated by the Texas Hospital Association in conjunction with the Texas Organization of Nurse Executives, Texas A&M Health Science Center Rural and Community Health Institute, and TMF Health Quality Institute.

"This is one simple, but important step to help ensure the safety of our patients," said Joel Suits, director of quality and compliance at Richards Memorial Hospital. "Each wristband, by virtue of its color, expresses a particular care directive for clinicians. With all hospitals agreeing to use the same colors, we can reduce the potential for error."

Three color-coded "alert" wristbands are being used in Texas as well as in hospitals in more than 25 other states.

In addition to the meaning associated with the specific color, the alert is written on the wristband to reduce the chance of confusion.

Familiarity

It's important for patients and family members to understand the meaning behind the wristband colors, Suits added.

"By knowing the meaning of the colored wristbands, you can help caregivers meet your needs," he said. "If you have allergies to foods, pollens or medications, share that information when you are admitted. If you have a tendency to lose your balance, tell your nurse. And if you have an advance directive, please let your caregivers know so that they can honor your wishes."

Suits also noted that when you come to the hospital, you should leave any "social cause" wristbands at home to avoid confusion.

For more information about Richards Memorial Hospital's standardized wristband initiative, contact Suits at 512-446-4500.

WRISTBAND COLOR CODES • Red means allergy alert. • Yellow means risk of falls. • Purple means the physician has written a do-notresuscitate order based on the patient's advance directives.


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