National Standards Emerging for Patient ID in Hospitals

Use of colored wristbands is widespread in hospitals across the country. Different colors signify such things about a patient, such as allergies, a “do not resuscitate” order, and fall risk. But the widespread use of colored patient wristbands in hospitals has lacked uniformity across the country. Different hospitals use the same color to code for different things. This is often a problems when doctors and nurses work at more than one hospital where wrist band colors mean different things. In extreme cases, patients who did not have a “do not resuscitate” (DNR) order were mistaken as having a DNR based on their bracelet color. Confusion about the meaning of a colored wrist band has similarly contributed to problems when phlebotomists visit the patient to collect laboratory specimens.

To address the problems caused by colored wristbands, the Western Region Alliance of Patient Safety (WRAPS) was formed earlier this year, in January of 2007. This Arizona-based effort has grown to include hospital systems in seven states. The group has agreed on three colored wristbands: red for allergy alerts; yellow for fall risk patients; and purple for patients with a do not resuscitate order. “The wristbands don’t replace the medical record, but they are the first line of communication,” said Barb Avery, project director at the Arizona Hospital and Healthcare Association. WRAPS hopes that the standards it creates will be adopted nationally.

The development of a national body for the standardization of wristbands is probably not far off. Beyond assigning colors to conditions, research must be done on whether or not specific allergies should be printed on the bracelets, whether or not having patients wear DNR bracelets decreases the quality of their care, and other issues. The standardization of the colors of wristbands will help hospitals improve the quality of patient care and avoid costly lawsuits that may arise from errors made because of wristband color.

The laboratory community should take note of this latest development in standardization of patient care. Phlebotomists will find that bracelets may make it easier to verify patient identity before doing a blood draw. Soon, we can expect hospital wristbands to be standardized with the same precision as the order of draw is standardized by the National Committee for Clinical Laboratory Standards.

Finally, Dark Daily observes that this standardization of patient ID wrist band colors could have been accomplished decades ago, simply by agreement among the manufacturers of these products. It is no coincidence that the current patient safety movement is driving the standardization of many aspects of healthcare. When providers, such as hospitals and physicians, realize that their rate of medical errors is being measured and posted for the public to see, they become motivated to do better.

That is why laboratory managers and pathologists should expect to see a continual streak of such standardization and quality improvement projects across the hospital industry. Transparency in medical errors and improved patient outcomes is already having the effect desired by the nation’s major employers when they launched the Leapfrog Group and similar efforts to improve the performance of the American healthcare system.

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