color-coded wristband standardization in minnesota wristband standardization in minnesota 3 ......
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Address: 2550 University Ave. W., Suite 350-S • St. Paul, MN 55114-1900 Phone: (651) 641-1121 Online: www.mnhospitals.org
Distributed November 2007
Implementation Toolkit
“Patient safety is a top priority”
Sponsored by:
Color-codedWristband
Standardizationin Minnesota
Minnesota Hospital Association (MHA) produced this publication with permission from the Arizona Hospital and Healthcare Association. MHA members should contact MHA at (651) 641-1121 with any questions.Copyright © 2007 Arizona Hospital and Healthcare Association (AzHHA). Users may copy this publication for noncommercial purposes only so long as authorship is attributed to AzHHA (but not in any way that suggests AzHHA endorses you or your use of the publication). The colors for DNR (purple), Allergy (red) and Fall Risk (yellow) cannot be changed if using any portion of this manual.
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Table of ContentsExecutive Summary
Background ........................................................................ 3
Recommendations for AdoptionStrategies to Reduce Reliance on Wristbands...................4Human Factors Considerations .................................... 5-6The Colors / FAQs..........................................................7-11Risk Reduction Strategies............................................12-13
Policy and ProcedureSample P&P........................................................... 15-18Patient Refusal Form......................................................... 19
Staff and Patient Education MaterialsStaff Education –Training Tips and Tools .....................21-29Staff Brochure ..............................................................30-31Patient Brochure...........................................................32-33PowerPoint Presentation..............................................34-40
Work Plan – How to ImplementWork Plan Guide...........................................................42-43Task Charts...................................................................44-53
AcknowledgementsMHA Wristband Task Force............................................... 54Sponsorship ...................................................................... 54
Wristband Product Order Information ................................ 55
St. John Products ............................................................57-61
Minnesota Hospital Association (MHA) produced this publication with permission from the Arizona Hospital and Healthcare Association. MHA members should contact MHA at (651) 641-1121 with any questions.© Copyright 2007 Arizona Hospital and Healthcare Association. All rights reserved. No part of this publication may be reproduced in any form without permission of the Arizona Hospital and Healthcare Association.
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learned that though there is limited, or lack thereof, research indicating how standardizing color coded wristbands impacts patient safety, experience from other states indicate that there have not been safety issues during transition to the new standard. In fact, caregivers welcomed the standardization due to potential confusion caused by the numerous variations in the use of color-coded “alert” wristbands.The MHA board recommends all hospitals work toward reducing reliance on the use of color-coded wristbands (see p. 4 for recommended strategies). In the interim the following color coded wrist bands should be used:
Patient safety is a top priority in Minnesota. We accomplish this in several ways, one which will now include Minnesota hospitals using the same five colors for “alert” wristbands. The goal is that all Minnesota hospitals that use wristbands to communicate an alert will adopt the same colors. The issue of wristband colors was first raised by the Pennsylvania Patient Safety Authority when there was an event in which a clinician nearly failed to rescue a patient who had a cardiopulmonary arrest because the patient had been incorrectly designated as “DNR” (do not resuscitate). The source of the confusion was that a nurse had incorrectly placed a yellow wristband on the patient. In this hospital, the color yellow signified that the patient should not be resuscitated. In a nearby hospital, in which this nurse also worked, yellow signified “restricted extremity,” meaning that this arm is not to be used for drawing blood or obtaining IV access. Fortunately, in this case, another clinician identified the mistake, and the patient was resuscitated. However, this “near miss” highlights a potential source of error and an opportunity to improve patient safety by re-evaluating the use of color-coded wristbands. Surveys have found up to 10 different colors for DNR and seven various colored bands designating 29 different conditions.
MHA Patient Safety CommitteeTo proactively address this issue, the MHA Patient Safety Committee commissioned a task force in April of 2007 to evaluate whether or not there should be a statewide standard for wristband colors in Minnesota. At that time there were 11 states that had adopted various standards for wristband colors. The task force
Executive Summary
Motion Approved by MHA Board August 10, 2007
Recognizing that current variations in the use of color-coded “alert” wristbands may cause confusion among caregivers, staff, and patients and can lead to patient harm, the Minnesota Hospital Association’s Patient Safety Committee proposes that the MHA board adopt the following resolution:
The Minnesota Hospital Association recommends that all hospitals work toward reducing reliance on and eventually eliminating the use of color wristbands by collectively developing more effective ways to communicate emergency information and patient risks. In the interim, if an organization uses colored wristbands to communicate patient information or risks, the following colors should be used to indicate the respective alert:
Red Allergy
Yellow Fall Risk
Purple DNR
Pink Restricted Extremity
Green Latex Allergy
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Strategies to Reduce Reliance on Wristbands
Suggested alternative methods for communicating alerts:
Signage — If signage is used, the color schema should
be consistent with recommended colors: purple for DNR, red
for allergy, yellow for fall risk, pink for restricted extremity and
green for latex allergy.
Hand-off communication — According to the
joint commission, ineffective communication is the most
frequently cited category of root causes of sentinel events.
Effective communication, which is timely, accurate, complete,
unambiguous, and understood by the recipient, reduces
error and results in improved patient safety. Implementing
a standardized approach to “hand-off” communications is
one of Joint Commission’s National Patient Safety Goals.
The primary objective of a “hand-off” is to provide accurate
information about a patient’s care, treatment, and services,
current condition and any recent or anticipated changes. This
would include communication alerts.
Situation-Background-Assessment-Recommendation (SBAR) is one technique to address
hand-off communication. The main purpose of the SBAR
technique is to improve the effectiveness of communication
through standardization of the communication process.
Nurses often take more of a narrative and descriptive
approach to explaining a situation, while physicians usually
want to hear only the headlines of a situation. The SBAR
technique closes the gap between these two approaches,
allowing communicators to understand each other better.
Michael Leonard, M.D., physician coordinator of Clinical
Informatics, along with colleagues Doug Bonacum and
Suzanne Graham at Kaiser Permanente of Colorado in
Evergreen, Colorado, developed the (SBAR) technique.
More information on hand-off communication and SBAR can
be found at: http://www.jcipatientsafety.org/15274/ and http://
www.jcipatientsafety.org/15398/.
Stickers — Placing a sticker on the patient’s chart is an
alternative method to communicate alerts. If stickers are used,
the color schema should be consistent with recommended
colors: purple for DNR, red for allergy, yellow for fall risk, pink
for restricted extremity and green for latex allergy.
Technology — Bar coding: The FDA issued a final rule
in 2004 that requires a bar code including the National Drug
Code (NDC) on most prescription drugs and on certain over-
the-counter drugs. Bar codes on drugs would help prevent
medication errors when used with a bar code scanning
system and computerized database. FDA estimates that the
bar code rule will result in more than 500,000 fewer adverse
events over the next 20 years. More information on bar coding
can be found at http://www.fda.gov/oc/initiatives/
barcode-sadr/fs-barcode.html.
Computer Physician Order Entry (CPOE) —With CPOE, physicians enter orders into a computer rather
than on paper. Orders are integrated with patient information,
including laboratory and prescription data. The order is
then automatically checked for potential errors or problems.
Specific benefits of CPOE include prompts that warn against
the possibility of drug interaction or allergy. More information
on CPOE can be found at: http://www.leapfroggroup.org/
media/file/Leapfrog-Computer_Physician_Order_Entry_Fact_
Sheet.pdf.
List allergies on medication sheet
The ultimate goal of the MHA board motion is to eventually reduce the reliance on wristbands. This goal can be successfully achieved while maintaining patient safety by using technology such as using the patient
identification wristband with bar coding. Understanding that technology, such as bar coding and CPOE, is not a solution for all hospitals, additional strategies are listed below.
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Human Factors Considerations
• Human error most frequently arises from stressful, busy, uncommon situations. Because of the dynamic nature of healthcare, it is important to create our systems to help staff do their work. By standardizing wristbands across the state, staff no longer have to remember symbols or colors specific to hospitals, they are able to learn a single set of rules for every hospital.
• The text information contained on the wristband should not wrap around the entire wrist. This decreases the chance that information will be missed because it is on the other side of the band and was not seen.
• The MINIMAL amount of information that is required should be displayed on the wristband. Key data should be placed where it is seen first.
• Wristbands should be designed so that they highlight SPECIFIC, PERTINENT information. Too much information can be difficult to distinguish and can get misread or misinterpreted, especially when in a hurry. Visual cues, such as highlighting, can be used to make the information ‘pop out.’ However, the cue should be used consistently, (i.e., if one bracelet is going to have the patient’s allergies written out on the band,
Human Factors:
• The study of human capabilities and limitations – How we think– How we act / What we do– What we use to do it
• And the application of those principles to the design of tools, systems, tasks, jobs and environments
• For comfortable, effective, and safe human use
Within healthcare, the science of human factors addresses human performance within medical systems, particularly as it relates to processes of care, error management, and patient safety. Error management indicates not only decreasing errors themselves, but also decreasing the opportunity for error-causing situations to arise, by designing safe systems that take a human’s capabilities and limitations into account throughout the design process. This is of primary importance when addressing the design of wristbands, a tool used daily in healthcare by every provider.
To fully integrate human factors into wristband design, there are a few key points to emphasize:
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Human Factors Considerations continued
all wristbands should have allergy information written out on the band). Also, the style and placement of information should remain consistent for every band. Again, only the absolute minimal amount of information should be placed on the band. Limit abbreviations.
If using icons: Icons can facilitate visual search for information: HOWEVER, the icon must make sense to the user. In other words, if choosing to use an icon, use something the majority of users recognize as representative of the information trying to be conveyed.
If using numbers: Numbers can be read more quickly if they are in a column than in a row. However, remember that information should not wrap around the entire wrist.
If using any extended text: Font should never be smaller than 8 pt. Spacing between lines is very important. This is called “white space.” Lines should always be at least single spaced. For short, factual information, a table with lines is helpful to keep information separate.
Smith, Joseph B. Birth date: September 30, 1947
DNR Male
• If using text on the wristband, be sure to use large letters that are NOT italicized. Italics are more difficult for the eyes to quickly read and interpret.
• The text should always be in a color that contrasts the color of the bracelet. For example: blue print on a black background or vice versa is difficult to read. But black print on a yellow bracelet is very easy to read.
• Reading improves with an increase in text size, but only up to a critical point, at which it levels off. That critical point is dependent on task; therefore, it would be beneficial to observe the task and determine how readable the text on the bracelets needs to be to allow for optimal performance.
In closing, taking human factors – human capabilities and limitations – into account will allow for a safer and more intuitive system. As a rule of thumb, simpler is ALWAYS better. The recommendations here are based on a broad spectrum of possible bracelet designs, highly dependent on the amount of text and the length of text. The recommendations here are based on scientific research into human abilities to see, read, and perceive and interpret information. For a complete list of references, please email Sarah Henrickson at [email protected].
Human Factors Resources
Helping clinicians to find data and avoid delays. The Lancet, Volume 352, Issue 9138, Pages 1462-1466, E. Nygren, J. Wyatt, P. Wright
How to limit clinical errors in interpretation of data. The Lancet, Volume 352, Issue 9139, Pages 1539-1543, P. Wright, C. Jansen, J. Wyatt
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Q. Why should we consider adopting this?
A. Wristbands are used in many Minnesota hospitals to communicate an alert. Until more effective ways of communicating patient DNR designation are developed, a wristband can serve as a quick warning to communicate this alert.
Recommendations for Adoption — Purple
Do Not Resuscitate
Recommendation:
It is recommended that hospitals adopt the color of PURPLE for the Do Not Resuscitate designation with the letters embossed / printed on the wristband, “DNR.”
While there is much discussion regarding the issue of “to band or not to band,” a literature review to date has not identified a better intervention conclusively. One may say, “In the good old days, we just looked at the chart and didn’t band patients at all.” However, those days consisted of a workforce base that was largely employed by the hospital. Because an increasing number of
Q. Why not use blue?
A. At first, blue was considered a great color choice; however, many hospitals utilize “Code Blue” to summon the resuscitation team. By also having the DNR wristband as “no code” there was the potential to create confusion. “Does blue mean we code or do not code?” To avoid creating any second guesses in this critical moment, we opted to not use blue.
healthcare providers working in hospitals are not hospital based staff, it is imperative that current processes take this into consideration. Travel staff may not be familiar with how to access information (as in the use of computerized charts), may not be familiar with where to find information in the medical record, or even where to find the medical record. When seconds count, as in a code situation, we believe having an alert wristband on the patient will serve as a great tool. Similar to a second identifier, it will serve as a ready communication in a crisis situation, an evacuation situation, or in a transit situation.
FAQs
DNR
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Q. Why did you select red?
A. Red was selected to be consistent with the 3 state models evaluated, which use the color red to indicate an allergy. It just made sense to continue with an established color that has been implemented in 11 other states.
Allergy Alert
Recommendations for Adoption — Red
Recommendation:
It is recommended that hospitals adopt the color of RED for the Allergy Alert designation. Hospitals should develop a consistent process for indicating specific allergy (noted in medical record, written on band etc.).
Q. Are there any other reasons for using red?
A. Yes there are. Our research of other industries tells us that red has an association that implies extreme concern. The American National Standards Institute (ANSI) has designated certain colors with very specific warnings. ANSI uses red to communicate “Stop!” or “Danger!” We think that message should hold true for communicating an allergy status. When a caregiver sees a red allergy alert wristband they are prompted to “Stop!” and double check if the patient is allergic to the medication, food, or treatment they are about to receive.
FAQs
ALLERGY
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Q. Why did you select yellow?
A. Our research of other industries tells us that yellow has an association that implies “Caution!” Think of the traffic lights; proceed with caution or stop altogether is the message with yellow lights. The American National Standards Institute (ANSI) has designated certain colors with very specific warnings. ANSI uses yellow to communicate “Tripping or Falling hazards.” It fits well in healthcare too when associated with a Fall Risk. Caregivers would want to know to be on alert and use caution with a person who has history of previous falls, dizziness or balance problems, fatigability, or confusion about their current surroundings.
Q. Why even use an alert wristband for Fall Risk?
A. According to the Centers for Disease Control and Prevention (CDC), falls are an area of great concern in the aging population.
According to the CDC:
1. More than a third of adults aged 65 years or older fall each year.
2. Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.
Fall Risk
Recommendations for Adoption — Yellow
Recommendation:
It is recommended that hospitals adopt the color of YELLOW for the Fall Risk Alert designation with the words embossed / written on the wristband, “Fall Risk.”
3. Of those who fall, 20% to 30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death.
4. The total cost of all fall injuries for people age 65 or older in 1994 was $27.3 billion (in current dollars).
5. By 2020, the cost of fall injuries is expected to reach $43.8 billion (in current dollars). Hospital admissions for hip fractures among people over age 65 have steadily increased, from 230,000 admissions in 1988 to 338,000 admissions in 1999.
6. The number of hip fractures is expected to exceed 500,000 by the year 2040. As the aging population enters the acute care environment, one must consider the risk that is present and do all possible to communicate that to hospital staff. For more information about falls and related statistics, go to: http://www.cdc.gov/ncipc/factsheets/fallcost.htm.
Falls account for more than 70 percent of the total injury-related health cost among people 60 years of age and older.
FAQs
FALL RISK
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Q. Why even use an alert for Restricted Extremity?
A. The pink wristband has been used for breast cancer/lymphedema patients to indicate the extremity should not be used for starting an intravenous line or drawing laboratory specimens. Circulation is compromised in a patient with lymphedema and unnecessary invasive procedures should be avoided in the affected extremity. Pink wristbands can be used to indicate any other diagnosis that results in a restricted extremity.
RestrictedExtremity
Recommendations for Adoption — Pink
Recommendation:
It is recommended that hospitals adopt the color of PINK for the Restricted Extremity Alert designation with the words embossed / written on the wristband, “Restricted Extremity.”
Q. Why did you select pink?
A. Pink is consistent with other state models such as Pennsylvania and Colorado.
FAQs
RESTRICTEDEXTREMITY
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Q. Why even use an alert for Latex Allergy?
A. Latex allergy may cause anaphylaxis, a potentially life-threatening condition.
LatexAllergy
Recommendations for Adoption — Green
Recommendation:
It is recommended that hospitals adopt the color of GREEN for the Latex Allergy Alert designation with the words embossed / written on the wristband, “Latex Allergy.”
Q. Why did you select green?
A. Green is consistent with other state models such as Pennsylvania.
FAQs
LATEXALLERGY
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Risk Reduction Strategies
Color-coded “Alert” Wristbands / Risk Reduction Strategies
Quick Reference Card1. Use wristbands with the alert message pre-printed
(such as “DNR”).
2. Remove any “social cause” colored wristbands (such as “Live Strong”).
3. Remove wristbands that have been applied from another facility.
1. Use wristbands that are pre-printed with text that tells what the wristband means.
a. This can reinforce the color coding system for new clinicians, help caregivers interpret the meaning of the wristband in dim light, and also help those who may be color blind.
b. Eliminates the chance of confusing colors with alert messages.
2. Remove any “social cause” (such as Live Strong, Cancer, etc.) colored wristbands.
a. Be sure this is addressed in your hospital policy.
b. If that can’t be done, you can cover the wristband with a bandage or medical tape, but removal altogether is best.
3. Remove wristbands that have been applied from another facility.
a. This should be done during the entrance to facility process and/or admission.
b. Be sure this is addressed in your hospital policy.
4. Initiate banding upon admission, changes in condition, or when information is received during hospital stay.
5. Educate patients and family members regarding the wristbands.
6. Coordinate chart/white board/care plan/door signage information/stickers with same color coding.
7. Educate staff to verify patient color-coded “alert” arm bands upon assessment, hand-off of care and facility transfer communication.
4. Initiate banding upon admission, changes in condition, or information received during hospital stay.
5. Educate patients and family members regarding purpose and meaning of the wristbands.
a. Including the family in this is a safeguard for you and the patient.
b. Remind them that color coding provides another opportunity to prevent errors.
c. Use the Patient / Family Education brochure located in the toolkit.
6. Coordinate chart/white board/care plan/door signage information/stickers with same color coding.
For allergies, fall prevention, DNR, restricted extremity and latex allergy status.
7. Educate staff to verify patient color-coded “alert” wristbands upon assessment, hand-off of care and facility transfer communication.
The following information takes each risk reduction strategy and provides further detail and / or explanation of that strategy.
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To improve patient safety in the delivery of healthcare has become a goal for every organization. A part of that is to reduce risks for injury or harm whenever possible. By implementing risk reduction strategies, we demonstrate patient safety in a consistent fashion.
Risks are about events that, when triggered, may cause potential harm, significant injury or in the worse case scenario, death of a patient. The commitment to practice safely begins at the bedside and is underscored through leadership support to be proactive in the effort to ensure safe practice.
The initial step begins with risk identification. Trends in adverse events or “the risk thereof” are key to organizational claim management. Failure to rescue, medication errors, and falls consistently challenge organizations to improve patient safety and reduce losses. Medication errors and falls are among the highest reported incidents and are often underestimated “based on their everyday occurrence.” Human factors are often the root cause of such preventable events and are often related to a complicated communication process, an ever-changing environment, and inconsistent caregivers.
Communication is a leading contributing factor for sentinel events that occur in the healthcare setting. One method to assist with effective communication is using color coding for “alert” wristbands. This provides a simplified tool that, when standardized, provides a continuous communication link within an organization as well as between other healthcare facilities.
8. When possible, limit the use of colored arm bands.
a. Such as, for other categories of care (i.e. MRSA, tape).
9. Remember, the wristband is a tool to communicate an alert status.
a. Educate staff to utilize the patient, medical record information (physician order for DNR) as additional resource for verification process for allergies, fall risk, advance directives and restricted extremity.
10. If your facility uses pediatric wristbands that correspond to the Broselow color coding system for pediatric resuscitation, take steps to reduce any confusion between these Broselow colors and the colors on the wristbands used elsewhere in the facility.
Additional Points to Make:
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Policy and Procedure
ALLERGY
DNR
FALL RISK
RESTRICTEDEXTREMITY
LATEXALLERGY
PolicyandProcedureTemplate
Policy name: Color-coded Wristbands
1. Purpose
To have a standardized process that identifies and communicates patient specific
risk factors or special needs by standardizing the use of color-coded wristbands
based upon the patient s assessment, wishes, and medical status.
2. Objective - Color-coded Wristbands
Objectives are:
A. To reduce the risk of potential for confusion associated with the use of
color-coded wristbands.
B. To communicate patient safety risks to all health care providers.
C. To include the patient, family members, and significant others in the
communication process and promote safe health care.
D. To adopt the following risk reduction strategies:
1. A preprinted written descriptive text is used on the bands clarifying the
intent (i.e., Aller , Fall Ris , or DNR )
2. No handwriting is used on the wristband.
3. Colored wristbands may only be applied or removed by a nurse or
licensed staff person conducting an assessment.
4. If labels, stickers or other visual cues are used in the medical record to
communicate risk factors or wristband application, those cues should
use the same corresponding color and text to the colored band.
5. Social cause wristbands, such as the Live Str and other causes,
should not be worn in the hospital setting. Staff should have family
members take the social cause wristbands home or remove them from
the patient and store them with their other personal items. This is to
avert confusion with the color-coded wristbands and to enhance
patient safety practices.
6. Assist the patient and their family members to be a partner in the care
provided and safety measures being used. Patient and family education
should be conducted regarding:
a) The meanings of the hospital wristbands and the alert
associated with each wristband; and
b) The risks associated with wearing social cause wristbands
and why they are asked to remove them.
MHA wishes to acknowledge the Pennsylvania Color of Safety Task Force, which developed the initial policy that is the basis for this document.
3. Definitions
The following represents the meaning of each color-coded band:
Band Color Communicates
Red Allergy
Yellow Fall Risk
Purple DNR
Pink Restricted Extremity
Green Latex Allergy
4. Identification (ID) Bands in Admission, Pre-Registration Procedure and/or
Emergency Department
The colorless or clear admission ID wristbands are applied in accordance with
procedures outlined in organizational policy on patient ID and registration. These
ID bands may be applied by non-clinical staff in accordance with organizational
policy.
5. Color-coded Hospital Bands
During the initial patient assessment, data is collected to evaluate the needs of the
patient and a plan of care unique to the individual is initiated. Throughout the
course of care, reassessment is ongoing which may uncover additional pertinent
medical information, trigger key decision points, or reveal additional risk factors
about the patient. It is during the initial and reassessment procedures that risk
factors associated with falls, allergies, and DNR status are identified or modified.
Because this is an interdisciplinary process, it is important to identify who has
responsibility for applying and removing color-coded bands, how this information
is documented and how it is communicated. The following procedures have been
established to remove uncertainty in these processes:
A. Any patient demonstrating risk factors on initial assessment will have a
color-coded wristband placed on the same extremity as the patient ID band
by the nurse or licensed professional, if the nurse is unavailable. This
includes all in-patient, out-patient and emergency department patients.
B. The application of the band is documented in the chart by the nurse, per
hospital policy.
C. If labels, stickers or other visual cues are used to document in the record,
the stickers should correspond to band color and text.
D. Upon application of the colored band, the nurse will instruct the patient
and their family member(s) (if present) that the wristband is not to be
removed.
E. In the event that any color-coded wristband(s) have to be removed for a
treatment or procedure, a nurse will remove the bands. Upon completion
of the treatment or procedure, new bands will be made, risks reconfirmed,
and the bands placed immediately by the nurse.
6. Social Cause Wristbands
Following the patient ID process, a licensed clinician, such as the admitting nurse,
examines the patient for social cause wristbands. If social cause wristbands are
present, the nurse will explain the risks associated with the wristbands and ask the
patient to remove them. If the patient agrees, the band will be removed and given
to a family member to take home, or stored with the other personal belongings of
the patient. If the patient refuses, the nurse will request the patient sign a refusal
form acknowledging the risks associated with the social cause wristbands (see last
page of this section). In the event that the patient is unable to provide permission,
and family member(s) or a significant other is also not present, the licensed staff
member may remove the band(s) in order to reduce the potential of confusion or
harm to the patient.
7. Patient / Family Involvement and Education
It is important that the patient and family members are informed about the care
being provided and the significance of that care. It is also important that the
patient and their family member(s) be acknowledged as a valuable member of the
health care team. Including them in the process of color-coded wristbands will
assure a common understanding of what the bands mean, how care is provided
when the bands are worn, and their role in correcting any information that
contributes to this process. Therefore, during assessment procedures, the nurse
should take the opportunity to educate and re-educate the patient and their family
members about:
a) The meanings of the hospital wristbands and the alert
associated with each wristband;
b) The risks associated with wearing social cause wristbands
and why they are asked to remove them;
c) The nurse whenever a wristband has been removed and not
reapplied; or
d) Notify the nurse when a new band is applied and they have
not been given explanation as to the reason.
Patients and families have available to them a patient/family education brochure
(see pages 32-33) that explains this information as well.
8. Hand-Off in Care
The nurse will reconfirm color-coded wristbands before invasive procedures, at
transfer and during changes in level of care with patient/family, other caregivers,
and the patient s chart. Errors are corrected immediately.
Color-coded bands are not removed at discharge. For home discharges, the
patient is advised to remove the band at home. For discharges to another facility,
the bands are left intact as a safety alert during transfer. Receiving facilities
should following their policy and procedure for the banding process.
9. DNR (Do Not Resuscitate)
DNR (Do Not Resuscitate) status and all other risk assessments are determined by
individual hospital policy, procedure and/or physician order written within and
acknowledged within that care setting only. The color-coded wristband serves as
an alert and does not take the place of an order. Do Not Resuscitate orders must
be written and verification of Advanced Directives must occur.
10. Staff Education
Staff education regarding color-coded wristbands will occur during the new
orientation process and reinforced as indicated.
(Note to Hospitals: You should insert your specific language in this section so it
matches your annual processes and competencies, should you decide to include
color-coded wristbands in that process.)
11. Patient Refusal
If the patient is capable and refuses to wear the color-coded band, an explanation
of the risks will be provided to the patient/family. The nurse will reinforce that it
is their opportunity to participate in efforts to prevent errors, and it is their
responsibility as part of the team. The nurse will document in the medical record
patient refusals, and the explanation provided by the patient or their family
member. The patient will be requested to sign an acknowledgement of refusal by
the completion of a release.
Patient Identifier Information
Name: ____________________________________
PID: _____________________________________
DOB: ____________________________________
Admitting Physician: _______________________
{Facility Name}
{Form Number}
Patient Refusal to Participate in the Wrist Band Process
The above named patient refuses to: (check what applies)
Wear color coded alert wristbands.
The benefits of the use of color coded wristbands have been explained to me by a member
of the health care team. I understand the risk and benefits of the use of color-coded
wristbands, and despite this information, I do not give permission for the use of color-
coded wristbands in my care.
Remove Social Cause colored wristbands (like Live Str and others).
The risks of refusing to remove the Social Cause colored wristbands have been explained
to me by a member of the health care team. I understand that refusing to remove the
Social Cause wristbands could cause confusion in my care, and despite this information,
I do not give permission for its removal.
Reason provided (if any): ___________________________________________________
_________________________________________________________________________
_____________ ________________________________________________
Date / Time Signature / Relationship
_____________ ________________________________________________
Date / Time Witness Signature / Job Title
Color-coded Wristband Standardization in Minnesota
20
“Patient safety is a top priority”
Staff and Patient Education Materials
ALLERGY
DNR
FALL RISK
RESTRICTEDEXTREMITY
LATEXALLERGY
Color-coded Wristband Standardization in Minnesota
21
“Patient safety is a top priority”
Key Preparation Before You Start
Review your section under the “Implementation Work Plan” to be sure you have included all of your stakeholders in this process. Consider all of the stakeholders in your organization when it comes to color-coded wristbands and who is impacted in this system change.
Thoughts to consider:
1. While ultimately the nurses are the people that usually band the patient, the health unit clerks are greatly involved in the system process. Include them in the training. They can better assist the nurses when they have this information.
2. Consider the housekeeping staff. They are often present in a patient room when a patient is trying to get up or walking to the bathroom. If the housekeeping staff knows a yellow wristband means “Fall Risk,” and they see a patient trying to get up, they can call the nursing staff, alert them and potentially prevent a fall.
3. What about the dietary technicians? A red wristband means there is an allergy – and not just to medicines. Maybe it is a food allergy and the red wristband will alert them to check for that and note it in their profile.
4. Don’t make assumptions about the medical staff getting this information. Attendings, intensivists, residents and interns need to know what these colors mean. Pull them into the process. This promotes safe healthcare for all providing it and receiving it.
5. Who else? Take some time to quietly observe the activities of the day at one of the nurses stations. Just a 30 minute observation and you will probably “see” and “hear” things that make you remember another stakeholder. Include them in the education process. Once done, you can begin the actual training part.
Staff Education Training Tips
Photo compliments of Motion Computing
Color-coded Wristband Standardization in Minnesota
22
“Patient safety is a top priority”
Getting Started
Most people will use this brochure as the main teaching material. It contains most of the pertinent information staff need to know for this initiative. We suggest you do not give out the brochure until the end of your training because people may start reading the brochure instead of listening to you. Pass it out at the end of the meeting, but tell them up front that there is a brochure with all of the information you are presenting and you will pass it out later.
In 2005, a hospital in Pennsylvania submitted a report to the Pennsylvania Patient Safety Reporting System (PA-PSRS) describing an event in which clinicians nearly failed to rescue a patient who had a cardiopulmonary arrest because the patient had been incorrectly designated as “DNR” (do not resuscitate). The source of the confusion was that a nurse had incorrectly placed a yellow wristband on the patient. In this hospital, the color yellow signified that the patient should not be resuscitated. In a nearby hospital, in which this nurse also worked, yellow signified “restricted extremity,” meaning that this arm is not to be used for drawing blood or obtaining IV access. Fortunately, in this case, another clinician identified the mistake, and the patient was resuscitated. However, this “near miss” highlights a potential source of error and an opportunity to improve patient safety by re-evaluating the use of color-coded wristbands.
We want to thank and acknowledge this hospital for their transparency and disclosure of this event. It could have happened anywhere, and it has served as a “wake-up call” to many of us.
1Here are the main points you want to make during your training session:
Start with a story – adults want to know “why” they should do something; simply telling them they need to start doing this “because they do” is not sufficient information to get high levels of compliance. Besides, isn’t that what you would want to know, too? A story gives them information that makes the request relevant – so they want to comply.
This story is true. One panel of the brochure tells the story where a patient was almost not coded due to a mix up in the wristbands. The error was caught in time to quickly code the patient, but by telling this story most staff will understand how this error could happen to anyone – and they will be on board with this plan. The story goes like this:
Color-coded Wristband Standardization in Minnesota
23
“Patient safety is a top priority”
Introduce the Colors – There are five different color-coded “alert” wristbands that we are going to discuss that are a part of the statewide standardization.
RED means ALLERGY ALERT
YELLOW means FALL RISK
PURPLE means “DNR” or Do Not Resuscitate
PINK means RESTRICTED EXTREMITY
GREEN means LATEX ALLERGY
2
Seven Risk Reduction Strategies – In addition to the standardization of wristband colors in the state, we recommend seven other risk reduction strategies that should be initiated. These are suggested as a result of sentinel events that have occurred, near-miss events and common sense. This information is also in the staff brochure and can be cut out as a Quick Reference Guide and laminated, if you desire. Review these with staff now.
Color-coded “Alert” Wristbands / Risk Reduction Strategies
Quick Reference Card1. Use wristbands with the alert message pre-printed
(such as “DNR”).
2. Remove any “social cause” colored wristbands (such as “Live Strong”).
3. Remove wristbands that have been applied from another facility.
4. Initiate banding upon admission, changes in condition, or when information is received during hospital stay.
5. Educate patients and family members regarding the wristbands.
6. Coordinate chart/white board/care plan/door signage information/stickers with same color coding.
7. Educate staff to verify patient color-coded “alert” arm bands upon assessment, hand-off of care and facility transfer communication.
3
Color-coded Wristband Standardization in Minnesota
24
“Patient safety is a top priority”
1. Use wristbands that are pre-printed with text that tells what the wristband means.
a. This can reinforce the color coding system for new clinicians, help caregivers interpret the meaning of the wristband in dim light, and also help those who may be color blind.
b. Eliminates the chance of confusing colors with alert messages.
2. Remove any “social cause” (such as Live Strong, Cancer, etc.) colored wristbands.
a. Be sure this is addressed in your hospital policy.
b. If that can’t be done, you can cover the wristband with a bandage or medical tape, but removal altogether is best.
3. Remove wristbands that have been applied from another facility.
a. This should be done during the entrance to facility process and/or admission.
b. Be sure this is addressed in your hospital policy.
4. Initiate banding upon admission, changes in condition, or information received during hospital stay.
5. Educate patients and family members regarding purpose and meaning of the wristbands.
a. Including the family in this is a safeguard for you and the patient.
b. Remind them that color coding provides another opportunity to prevent errors.
c. Use the Patient / Family Education brochure located in the toolkit.
6. Coordinate chart/white board/care plan/door signage information/stickers with same color coding.
For allergies, fall prevention, DNR, restricted extremity, and latex allergy status.
7. Educate staff to verify patient color-coded “alert” wristbands upon assessment, handoffs of care and facility transfer communication.
The following information takes each risk reduction strategy and provides further detail and/or explanation of that strategy.
8. When possible, limit the use of colored arm bands.
Such as, for other categories of care (i.e. MRSA, tape).
9. Remember, the wristband is a tool to communicate an alert status.
Educate staff to utilize the patient, medical record information (physician order for DNR) as additional resource for verification process for allergies, fall risk, advance directives and restricted extremity.
10. If your facility uses pediatric wristbands that correspond to the Broselow color coding system for pediatric resuscitation, take steps to reduce any confusion between these Broselow colors and the colors on the wristbands used elsewhere in the facility.
Additional points to make:
Color-coded Wristband Standardization in Minnesota
25
“Patient safety is a top priority”
Teaching Patients - The Patient Education brochure is a companion document to the staff brochure. We know that how we say something is just as important as what we say. Patients and their loved ones are scared, vulnerable and unfamiliar with hospital ways. We need to communicate to them in a respectful and simple way without being condescending. The following text was written to serve as a “script” for staff so all could be delivering the same information to patients and families. By having a consistent message, we reinforce the information – this helps patients and families retain the information. Another benefit of having a consistent message is patients and families experience a sense of confidence in the healthcare system since we are all echoing each other. The text box below is taken directly from the staff brochure. This is the time to mention to staff there is a patient / family brochure that can be handed out (if your unit intends on doing that). Tell staff you will hand out the brochure to them so they can see what the patients will have when you are done presenting the material.
SCRIPT for any staff person talking to a patient or family
What is a Color-coded “Alert” Wristband? Color-coded alert wristbands are used in hospitals to quickly communicate a certain healthcare status, condition or an “alert” that a patient may have. This is done so every staff member can provide the best care possible.
What do the colors mean? There are FIVE different color-coded “alert” wristbands that we are going to discuss because they are going to be standardized throughout the state.
RED means ALLERGY ALERTIf a patient has an allergy to anything - food, medicine, dust, grass, pet hair, ANYTHING - tell us. It may not seem important to you but it could be very important in the care they receive.
YELLOW means FALL RISKWe want to prevent falls at all times. Nurses review patients all the time to determine if they need extra attention in order to prevent a fall. Sometimes, a person may become weakened during their illness or because they just had a surgery. When a patient has this color-coded alert wristband, the nurse is saying this person needs to be assisted when walking or they may fall.
PURPLE means “DNR” or Do Not ResuscitateSome patients have expressed an end-of-life wish and we want to honor that request.
PINK means RESTRICTED EXTREMITYWhen a patient has this color-coded wristband, the nurse is saying this patient’s extremity should be handled with extreme care. Other care providers are alerted to check with the nurse prior to any tests or procedures involving the restricted extremity.
GREEN means LATEX ALLERGYThe best way to prevent an allergic reaction is to avoid latex. This green wristband will alert the doctors, nurses and other healthcare professionals about your allergy.
4
Color-coded Wristband Standardization in Minnesota
26
“Patient safety is a top priority”
And finally…. Review with staff the points listed below. These are the items that are listed on the staff competency checklist so it is important to clarify that they have a good understanding of these items. You should emphasize, “this is what would impact your tasks every day…” and review those points. This is a good time to hand out your organization’s Policy & Procedure. Be sure your policy covers the below listed areas as they are also a part of the staff competency checklist. If your policy does not address any of the items on the staff competency checklist, then you should remove it from the form.
Go to MHA’s web site at www.mnhospitals.org. Click on “Priority Issues,” “Patient Safety,” then “Tools.” The toolkit can be found under the “Minnesota Wristband Color Toolkit” heading.
5
• Color code – what do the five colors mean?
• Who can apply the wristband to the patient?
• When does the application of the color-coded wristband(s) occur?
• Policy on patients not allowed to wear the “Social Cause” bands
• Patient education and how to communicate (script) the information with patients/families
• Need for re-application of wristband
• Communication regarding wristbands during transfers and other reports
• Patient refusal to comply with policy
• Discharge instructions for home and/or facility transfer
Day / Date / Time: ____________________________________________________________
Location: ____________________________________________________________________
Day / Date / Time: ____________________________________________________________
Location: ____________________________________________________________________
Day / Date / Time: ____________________________________________________________
Location: ____________________________________________________________________
Questions? Contact: ___________________________________________ ext: ____________
“Patient safety is our first priority”
Join us on the following dates for the training session about Color-coded Alert Wristband Standardization.
GotColor?
DNR
ALLERGY
FALL RISKRESTRICTEDEXTREMITY
LATEXALLERGY
Staff Sign-In Sheet
Date :____________________ Unit/Dept/ Location _________________________________
Educator: __________________________________________________________________
Topic: Color-coded Alert Wristbands
Objective: 1. To inform staff of the new process and colors of the Allergy, Fall Risk, DNR, Restricted Extremity and Latex Allergy wristbands.
2. Staff to demonstrate understanding of information through feedback of information.
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Name/Title: ____________________________________________________________________ Shift: _______________
Patient Color-coded Alert Wristband Process Date Method
UsedSupervisors’
Initials Comments
Color Code – what do the five colors mean?
Who can apply the wristband to the patient?
When does the application of the wristband(s) occur?
Policy on patients not allowed to wear the “Social Cause” bands
Patient education and how to communicate (script) the information with patients / families
Need for re-application of wristband
Communication regarding wristbands during transfers and other reports
Patient refusal to comply with policy
Discharge instructions for home and /or facility transfer
Staff Competency Checklist
Purpose: These are the standards of the technical competencies necessary for performance and/or clinical practice.
__________________________________________________________________________________________Employee Signature Date
__________________________________________ _________________________________________Signature Initials Signature Initials
To meet competency standard the employee must demonstrate proficiency in performing the technical procedures safely as evidenced by department specific criteria.
Methods to Use: A. Demonstration D. Skills Lab G. OtherB. Direct Observation/Checklist E. Self Study/TestC. Video / PowerPoint Review F. Data Management
__________________________________________________________________________________________Employee Name Job Title
Supervisor’s initials signify competency
was met.
MHA wishes to acknowledge the Pennsylvania Color of Safety Task Force, which developed the initial policy that is the basis for this document.
How
this
all
got
start
ed…
The
issu
e of
wris
tban
d co
lors
was
firs
t ra
ised
by
the
Pen
nsyl
vani
a P
atie
nt S
afet
y A
utho
rity
whe
n th
ere
was
an
even
t in
whi
ch a
clin
icia
n ne
arly
faile
d to
res
cue
a pa
tient
who
had
a c
ardi
opul
mon
ary
arre
st b
ecau
se t
he p
atie
nt h
ad b
een
inco
rrec
tly
desi
gnat
ed
as “
DN
R”
(do
not
resu
scita
te).
The
so
urce
of
the
conf
usio
n w
as t
hat
a nu
rse
had
inco
rrec
tly p
lace
d a
yello
w w
ristb
and
on th
e pa
tient
. In
thi
s ho
spita
l, th
e co
lor
yello
w s
igni
fied
that
the
pa
tient
sho
uld
not
be r
esus
cita
ted.
In
a ne
arby
ho
spita
l, in
whi
ch t
his
nurs
e al
so w
orke
d, y
ello
w
sign
ified
“re
stric
ted
extr
emity
,” m
eani
ng t
hat
this
ar
m is
not
to b
e us
ed fo
r dra
win
g bl
ood
or o
btai
ning
IV
ac
cess
. Fo
rtun
atel
y,
in
this
ca
se,
anot
her
clin
icia
n id
entifi
ed th
e m
ista
ke, a
nd th
e pa
tient
was
re
susc
itate
d. H
owev
er,
this
“ne
ar m
iss”
hig
hlig
hts
a po
tent
ial
sour
ce o
f er
ror
and
an o
ppor
tuni
ty t
o im
prov
e pa
tient
saf
ety
by r
e-ev
alua
ting
the
use
of
colo
r-co
ded
wris
tban
ds.*
W
e w
ant
to
than
k an
d ac
know
ledg
e th
is
hosp
ital
for
thei
r tr
ansp
aren
cy a
nd d
iscl
osur
e of
th
is e
vent
. It c
ould
hav
e ha
ppen
ed a
ny w
here
, and
it
has
serv
ed a
s a
“wak
e up
cal
l” to
man
y of
us.
*To
view
the
ent
ire s
afet
y al
ert
go t
o ht
tp://
ww
w.p
sa.
stat
e.pa
.us/
psa/
lib/p
sa/a
dvis
orie
s/v2
_s2_
sup_
_adv
isor
y_de
c_14
_200
5.pd
f
The B
ig P
ictu
reS
tate
wid
e w
ristb
and
colo
r st
anda
rdiz
atio
n is
be
ing
adop
ted
thro
ugho
ut M
inne
sota
, in
add
ition
to
man
y so
uthw
este
rn s
tate
s th
roug
h th
e W
este
rn
Reg
ion
Alli
ance
fo
r P
atie
nt
Saf
ety
(WR
AP
S):
Ariz
ona,
Cal
iforn
ia, C
olor
ado,
Nev
ada,
New
Mex
ico
and
Uta
h. O
ther
sta
tes
incl
ude
Ohi
o, W
est V
irgin
ia
and
Pen
nsyl
vani
a. T
hat
mea
ns w
heth
er y
ou a
re
trav
elin
g on
vac
atio
n to
thes
e st
ates
or r
eloc
ated
to
wor
k in
ano
ther
sta
te,
mos
t ho
spita
ls w
ill b
e us
ing
cons
iste
nt c
olor
s.
Colo
r-co
ded w
rist
bands
in M
inneso
ta
Pat
ient
saf
ety
is a
top
prio
rity
for
Min
neso
ta.
To
proa
ctiv
ely
addr
ess
the
safe
ty r
isk
due
to w
ristb
and
colo
r va
riatio
n,
the
Min
neso
ta
Hos
pita
l A
ssoc
iatio
n (M
HA
) P
atie
nt
Saf
ety
Com
mitt
ee c
omm
issi
oned
a t
ask
forc
e to
eva
luat
e w
heth
er o
r no
t th
ere
shou
ld
be a
sta
tew
ide
stan
dard
for
wris
tban
d co
lors
in
Min
neso
ta.
At
that
tim
e th
ere
wer
e 11
st
ates
th
at
had
adop
ted
vario
us s
tand
ards
for
wris
tban
d co
lors
. T
houg
h th
ere
is li
mite
d, o
r la
ck t
here
of,
rese
arch
ind
icat
ing
how
sta
ndar
dizi
ng
colo
r co
ded
wris
tban
ds im
pact
s pa
tient
sa
fety
, exp
erie
nce
from
oth
er s
tate
s th
at
have
impl
emen
ted
a st
anda
rd in
dica
ted
that
the
re h
ave
not
been
saf
ety
issu
es
durin
g tr
ansi
tion
to t
he n
ew s
tand
ard.
In
ad
ditio
n,
care
give
rs
wel
com
ed
the
stan
dard
izat
ion
due
to
pote
ntia
l co
nfus
ion
caus
ed
by
the
num
erou
s va
riatio
ns
in
the
use
of
colo
r-co
ded
“ale
rt” w
ristb
ands
.
Min
neso
ta h
as a
dopt
ed fi
ve c
olor
s:
RE
D m
ean
s A
LL
ER
GY
A
LE
RT
YE
LL
OW
mea
ns
FAL
L R
ISK
PU
RP
LE
mea
ns
“DN
R”
PIN
K m
ean
s “R
ES
TR
ICT
ED
EX
TR
EM
ITY
”G
RE
EN
mea
ns
“LA
TE
X A
LL
ER
GY
”
Sta
ff E
duca
tion
Reg
ardi
ng:
Colo
r-co
ded “
ale
rt”
wri
stbands
Info
rmat
ion
inte
nded
for
all s
taff,
clin
ical
an
d no
n-cl
inic
al.
Colo
r-co
ded A
lert
W
rist
bands
– A
Sta
tew
ide P
ati
ent
Safe
ty Init
iati
ve
Var
ious
su
rvey
s ha
ve
been
co
nduc
ted
indi
catin
g th
at t
here
are
ov
er 1
0 di
ffere
nt c
olor
s fo
r D
NR
and
th
at
seve
n va
rious
co
lore
d ba
nds
wer
e us
ed t
o de
sign
ate
twen
ty-n
ine
diffe
rent
con
ditio
ns.
Our
ris
k w
as a
ppar
ent.
Sol
utio
n: S
tand
ardi
ze th
e co
lors
be
ing
used
fo
r al
erts
: al
lerg
ies,
fa
ll ris
k, D
NR
, re
stric
ted
extre
mity
, an
d la
tex
alle
rgy
in
all
Min
neso
ta
hosp
itals
.
How
to te
ll th
e pa
tient
s w
hat
the
diff
eren
t col
ors
mea
n?
How
we
say
som
ethi
ng i
s ju
st
as i
mpo
rtan
t as
wha
t w
e sa
y. T
he
next
col
umn
is a
scr
ipt
you
can
use
to t
ell
your
pat
ient
s /
fam
ilies
abo
ut
the
colo
r-co
ded
aler
t wris
tban
ds a
nd
wha
t th
ey m
ean.
If
ever
yone
say
s it
the
sam
e w
ay,
ther
e is
a b
ette
r ch
ance
pa
tient
s an
d fa
mili
es
will
un
ders
tand
wha
t we
are
sayi
ng.
Oth
er
Ris
k R
educt
ion
Str
ate
gie
sSta
ff S
hould
Know
SC
RIP
TFo
r an
y st
aff p
erso
n ta
lkin
g to
a
patie
nt o
r fa
mily
Wha
t is
a C
olor
-cod
ed “
Ale
rt”
Wri
stba
nd?
Col
or-c
oded
ale
rt w
ristb
ands
are
use
d in
hos
pita
ls
to q
uick
ly c
omm
unic
ate
a ce
rtai
n he
alth
care
sta
tus,
co
nditi
on o
r an
“al
ert”
tha
t a
patie
nt m
ay h
ave.
Thi
s is
do
ne s
o ev
ery
staf
f mem
ber
can
prov
ide
the
best
car
e po
ssib
le.
Wha
t do
the
col
ors
mea
n?
Ther
e ar
e fiv
e di
ffere
nt c
olor
-cod
ed “
aler
t” w
ristb
ands
th
at h
ave
been
sta
ndar
dize
d th
roug
hout
the
stat
e.
RE
D m
eans
ALL
ER
GY
ALE
RT
If yo
u ha
ve a
n al
lerg
y to
any
thin
g –
food
, m
edic
ine,
du
st,
gras
s, p
et h
air,
AN
YTH
ING
– t
ell
us.
It m
ay n
ot
seem
impo
rtan
t to
you
but i
t cou
ld b
e ve
ry im
port
ant i
n th
e ca
re y
ou r
ecei
ve.
YELL
OW
mea
ns F
ALL
RIS
KW
e w
ant
to p
reve
nt fa
lls a
t al
l tim
es. Y
our
prov
ider
will
de
term
ine
if yo
u ne
ed e
xtra
att
entio
n in
ord
er to
pre
vent
a
fall.
Som
etim
es,
a pe
rson
may
bec
ome
wea
kene
d du
ring
thei
r ill
ness
or
beca
use
they
just
had
a s
urge
ry.
Whe
n a
patie
nt h
as t
his
colo
r-co
ded
aler
t w
ristb
and,
it
indi
cate
s th
is p
erso
n ne
eds
to b
e as
sist
ed w
hen
wal
king
or
they
may
fall.
PU
RP
LE m
eans
“D
NR
” or
Do
Not
Res
usci
tate
Som
e pa
tient
s ha
ve e
xpre
ssed
an
end-
of-li
fe w
ish
and
we
wan
t to
hono
r th
at w
ish.
PIN
K m
eans
Res
tric
ted
Ext
rem
ity
Whe
n a
patie
nt h
as th
is c
olor
-cod
ed w
ristb
and,
the
heal
th p
rovi
der i
s sa
ying
this
pat
ient
’s e
xtre
mity
sho
uld
be h
andl
ed w
ith e
xtre
me
care
. Oth
er c
are
prov
ider
s ar
e al
erte
d to
che
ck w
ith th
e nu
rse
prio
r to
any
test
s or
pr
oced
ures
.
GR
EE
N m
eans
Lat
ex A
llerg
yW
hen
a pa
tient
has
this
col
or-c
oded
wris
tban
d, it
indi
cate
s an
alle
rgic
reac
tion
to la
tex.
Thi
s gr
een
wris
tban
d w
ill a
lert
th
e do
ctor
s, n
urse
s, a
nd o
ther
hea
lth c
are
prof
essi
onal
s ab
out y
our a
llerg
y.
Col
or-c
oded
“A
lert
” W
rist
band
s / R
isk
Red
ucti
on S
trat
egie
sQ
uick
Ref
eren
ce C
ard
1. U
se w
ristb
ands
with
the
aler
t mes
sage
pre
-prin
ted
(suc
h as
“D
NR
”).
2. R
emov
e an
y “s
ocia
l cau
se”
colo
red
wris
tban
ds
(suc
h as
“Li
ve S
tron
g”)
.
3. R
emov
e w
ristb
ands
that
hav
e be
en a
pplie
d fr
om
anot
her
faci
lity.
4. In
itiat
e ba
ndin
g up
on a
dmis
sion
, cha
nges
in
cond
ition
, or
whe
n in
form
atio
n is
rec
eive
d du
ring
hosp
ital s
tay.
5. E
duca
te p
atie
nts
and
fam
ily m
embe
rs r
egar
ding
th
e w
ristb
ands
.
6. C
oord
inat
e ch
art/
whi
te b
oard
/car
e pl
an/d
oor
sign
age
info
rmat
ion
/stic
kers
with
sam
e co
lor
codi
ng.
7. E
duca
te s
taff
to v
erify
pat
ient
col
or-c
oded
“al
ert”
ar
m b
ands
upo
n as
sess
men
t, ha
nd-o
ff o
f car
e an
d fa
cilit
y tr
ansf
er c
omm
unic
atio
n.
Our
hosp
ital is
pro
ud t
o b
e a
support
er o
f
this
work
,
mak
ing h
ealt
hca
re
safe
r and b
ette
r fo
r
pati
ents
and t
hei
r
fam
ilies.
Min
neso
ta h
ealt
hcar
e
prov
ider
s ar
e w
orki
ng
toge
ther
to
mak
e
pati
ents
saf
e.
We
acco
mpl
ish
this
goa
l
by w
orki
ng t
oget
her
on p
roje
cts
like
usin
g
the
sam
e co
lor-
code
d
wri
stba
nds.
Patie
nt S
afet
y:
Unde
rsta
ndin
g w
hat y
our
colo
r-co
ded
“ale
rt”
wris
tban
ds m
ean
Pho
to c
ompl
imen
ts o
f Mot
ion
Com
putin
g
Sta
tew
ide
Pat
ient
S
afet
y In
itia
tive
sP
atie
nt s
afet
y is
a t
op p
riorit
y fo
r M
inne
sota
. W
e ac
com
plis
h th
is i
n se
vera
l w
ays,
one
whi
ch i
nclu
des
us
ing
the
sam
e co
lors
fo
r “a
lert
” w
ristb
and
s. T
his
initi
ativ
e is
not
onl
y th
roug
hout
our
sta
te,
but
in
man
y ot
her
stat
es
incl
udin
g A
rizon
a,
Cal
iforn
ia,
Col
orad
o,
Nev
ada,
N
ew M
exic
o, O
hio,
Ore
gon,
Ohi
o,
Pen
nsyl
vani
a,
Uta
h,
and
W
est
Virg
inia
.
Wha
t is
a C
olor
-cod
ed
“Ale
rt”
Wri
stba
nd?
Ale
rt
wris
tban
ds
are
used
in
ho
spita
ls t
o q
uick
ly
com
mun
icat
e a
cert
ain
heal
th c
are
stat
us o
r an
“a
lert
” th
at a
pat
ient
may
hav
e. T
his
is d
one
so e
very
sta
ff m
emb
er c
an
pro
vid
e th
e b
est c
are
pos
sib
le, e
ven
if th
ey d
o no
t kn
ow t
hat
pat
ient
. Th
e d
iffer
ent
colo
rs
have
ce
rtai
n m
eani
ngs.
The
wor
ds
for
the
aler
ts
are
also
writ
ten
on t
he w
ristb
and
to
red
uce
the
chan
ce o
f co
nfus
ing
the
aler
t m
essa
ges.
best
and
saf
est h
ealth
car
e to
all
of o
ur p
atie
nts.
Also
, if y
ou h
ave
an A
dvan
ce D
irect
ive,
tell
us s
o. A
n Ad
vanc
e D
irect
ive
tells
you
r doc
tor w
hat k
ind
of c
are
you
wou
ld lik
e if
you
beco
me
unab
le to
mak
e m
edic
al
deci
sion
s. W
e w
ant t
o re
spec
t and
hon
or a
pat
ient
’s
wis
hes
and
that
is d
one
best
whe
n w
e ha
ve a
ll of
the
info
rmat
ion.
RE
D m
eans
ALL
ER
GY A
LER
T
ALL
ER
GY
If yo
u ha
ve a
n al
lerg
y to
any
thin
g –
food
, m
edic
ine,
du
st, g
rass
, pet
hai
r, A
NY
THIN
G –
tell
us. I
t may
not
se
em im
port
ant t
o yo
u bu
t it c
ould
be
very
impo
rtan
t in
the
care
you
rece
ive.
YE
LLO
W m
eans
FA
LL R
ISK
FALL
RIS
KW
e w
ant
to p
reve
nt f
alls
at
all t
imes
. Yo
ur p
rovi
der
will
det
erm
ine
if yo
u ne
ed e
xtra
att
entio
n in
ord
er t
o pr
even
t a
fall.
Som
etim
es,
a pe
rson
may
bec
ome
wea
kene
d du
ring
thei
r ill
ness
or
beca
use
they
jus
t ha
d a
surg
ery.
Whe
n a
patie
nt h
as t
his
colo
r-co
ded
aler
t w
ristb
and,
it in
dica
tes
this
per
son
need
s to
be
assi
sted
whe
n w
alki
ng o
r the
y m
ay fa
ll.
Wha
t do
the
dif
fere
nt c
olor
s m
ean?
The
re a
re fi
ve d
iffer
ent
colo
r-co
ded
“al
ert”
wris
tban
ds
that
hav
e b
een
stan
dar
diz
ed t
hrou
ghou
t th
e st
ate.
PU
RP
LE m
eans
“D
NR
” or
Do
Not
Res
usci
tate
DN
R
Som
e pa
tient
s ha
ve e
xpre
ssed
an
end-
of-l
ife w
ish
and
we
wan
t to
hono
r tha
t.
PIN
K m
eans
“R
estr
icte
d E
xtre
mit
y”R
ES
TRIC
TED
EX
TRE
MIT
Y
Whe
n a
patie
nt h
as t
his
colo
r-co
ded
wris
tban
d, t
he
heal
th p
rovi
der i
s sa
ying
this
pat
ient
’s e
xtre
mity
sho
uld
be h
andl
ed w
ith e
xtre
me
care
. O
ther
car
e pr
ovid
ers
are
aler
ted
to c
heck
with
the
nur
se p
rior
to a
ny t
ests
or
pro
cedu
res.
GR
EE
N m
eans
“La
tex
Alle
rgy”
LATE
XA
LLE
RG
Y
Whe
n a
patie
nt h
as t
his
colo
r-co
ded
wris
tban
d, i
t in
dica
tes
an
alle
rgic
re
actio
n to
la
tex.
Th
is
gree
n w
ristb
and
will
ale
rt t
he d
octo
rs,
nurs
es,
and
othe
r he
alth
car
e pr
ofes
sion
als
abou
t you
r alle
rgy.
It is
im
porta
nt t
hat
the
patie
nt a
nd f
amilie
s kn
ow
thes
e co
lors
and
thei
r mea
ning
s be
caus
e yo
u ar
e th
e be
st s
ourc
e of
info
rmat
ion.
Kee
p us
info
rmed
.If
ther
e is
info
rmat
ion
we
do n
ot k
now
, suc
h as
a fo
od
alle
rgy
or a
tend
ency
to lo
se b
alan
ce a
nd a
lmos
t fal
l, sh
are
that
with
us
beca
use
we
wan
t to
pro
vide
the
Invo
lvin
g P
atie
nts
and
Fam
ily M
embe
rs
Color-coded Wristband Standardization in Minnesota
34
“Patient safety is a top priority”
Staff Education — The Tools continued
PowerPoint Presentation
This presentation was created to provide alternate teaching methods for the trainer. It can be used in large and small groups. The presentation with “Speaker’s Notes” is available on the Toolkit CD.
35
Patient Safety is a Top Prioritywww.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaExecutive Summary
Background:In 2005, Pennsylvania had a near misswhen there was confusion regardingwristband color that resulted in a patientbeing labeled DNR erroneouslyMHA Patient Safety Committeecommissioned a task force to evaluatewhether or not Minnesota should have astatewide standard for wristband colorsAs of August 2007, 11 states standardizedwristband colors
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaExecutive Summary
Surveys have found that:
up to 10 different colors are used for DNR
seven various colored bands are used todesignate twenty-nine different conditions
there are 11 variations of wristband colorsjust among MHA s Wristband Task Force.
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaExecutive Summary
In Oregon, there were 7 different ways todesignate Allergy status and 4 different waysto designate DNR status
www.mnhospitals.org
Insanity: doing
the same thing
over and over
again and
expecting
different results.
~ A. Einstein
Color Coded WristbandStandardization in MinnesotaWristband Taskforce
What did we do?Reviewed currentstandardization models in useDiscussed potential safetyissues during transition to newstandard and staff impact
Limited research on topic- incorporated humanfactors concepts
Other state experience indicated no safetyissues during transition
Caregivers have welcomed the standardizationdue to potential confusion caused by thenumerous variations in the colors.
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaWristband Taskforce
Task force findings discussed at full MHAPatient Safety Committee
Consensus to forward motion to MHAboard to standardize five condition alerts
Do Not Resuscitate DNR
Allergy
Fall Risk
Restricted Extremity
Latex Allergy
Board motion approved August 2007
36
Motion Approved by MHA Board
August 10, 2007
Recognizing that current variations in the use of color-coded alert wristbands may
cause confusion among caregivers, staff, and patients and can lead to patient harm,
the Minnesota Hospital Association s Patient Safety Committee proposes that the
MHA board adopt the following resolution:
The Minnesota Hospital Association recommends that all hospitals work toward
reducing reliance on and eventually eliminating the use of color wrist bands by
collectively developing more effective ways to communicate emergency
information and patient risks. In the interim, if an organization uses colored
wristbands to communicate patient information or risks, the following colors should
be used to indicate the respective alert:
*Red: allergy
*Yellow: fall risk
*Purple: DNR
*Pink: restricted extremity
*Green: latex allergy www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaWristband Toolkit
The Tool Kit contents include:
1. The colors for the alert designation
2. FAQs for the colors selected
3. A work-plan for implementation
4. Staff education including PowerPoint andcompetencies
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaWristband Toolkit
The Tool Kit contents include (cont.):
5. Sample policy and procedure
6. Patient education brochure
7. Human factors considerations
8. Suggested strategies to reduce reliance on wristbands
9. Vendor information for easy adoption
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaWristband Toolkit
Our safety as a state and success in
this effort will depend on the
participation and adoption of each and
every hospital in this state.
Color Coded WristbandStandardization in Minnesota
Recommendationsfor Adoption
Color Coded WristbandStandardization in MinnesotaAllergy
Red means Stop!
The American NationalStandards Institute has
designated red tocommunicate Stop! or
Danger!
Allergies
Recommendation:
Allergy - Red
It is recommended thathospitals adopt the color
RED for the ALLERGYALERT designation with thewords embossed / printed
on the wristband,ALLERGY.
37
Color Coded WristbandStandardization in MinnesotaRecommendation - RED for the Allergy Alert
1. Why Red?All 11 states to date have adopted red for allergy.
2. Any other reasons?Associated with other messages such as STOP! DANGER! due totraffic lights and ambulance/police lights.
3. Do we write the allergies on the wristband too?Hospitals will need to determine a consistent process for communicatingthe specific allergy. Some hospitals may chose to not write on the banddue to:
Legibility issues
Allergy list may change
Patient chart should be the source for the specifics
Color Coded WristbandStandardization in MinnesotaDo Not Resuscitate
Recommendation:
DNR - Purple
It is recommended thathospitals adopt the color
PURPLE for theDo Not Resuscitate
designation.
Calling CODE BLUE!
Many hospitals use codeblue to call a code team.
If Minnesota selected thecolor blue for the DNRwristband, the potential forconfusion exists.
Does blue mean Iresuscitate or I do notresuscitate?
Color Coded WristbandStandardization in MinnesotaDo Not Resuscitate
Recommendation - PURPLE for Do Not Resuscitate
1. Why not blue?
Should not be the same color that is used for calling a code
Registry, turnover, travelers, etc
2. Why not green?
Color blind
Go ahead confusion
3. If we adopt purple, do we still need to look in the chart?
Yes!
Code designation can and does change during a
patients stay
Color Coded WristbandStandardization in MinnesotaFall Risk
Recommendation:
Fall Risk - Yellow
It is recommended thathospitals adopt the colorYELLOW for the Fall RiskAlert designation with the
words embossed / written onthe wristband, Fall Risk.
Allergies
Falls account formore than 70
percent of the totalinjury-related
health cost amongpeople 60 years of
age and older.
Color Coded WristbandStandardization in MinnesotaFall Risk
Recommendation - YELLOW for Fall Risk
1. Why Yellow?Associated with Caution or Slow Down(Stop Lights and School Buses)
American National Standards Institute (ANSI)
All health care providers want to be alert to fall risks as theycan be prevented by anyone.
Allergies
Color Coded WristbandStandardization in MinnesotaRestricted Extremity
Allergies
Recommendation - Pink for Restricted Extremity
1. Why Pink?When a patient has this color-coded wristband, it is alerting the healthprovider that the patient s extremity should be handled with extreme care.This alerts providers to check with the nurse prior to any tests orprocedures.
2. Why even use an alert for Restricted Extremity?The pink wristband has been used for breast cancer/lymphedema patientsto indicate the extremity should not be used for starting an intravenous lineor drawing laboratory specimens. Circulation is compromised in a patientwith lymphedema and unnecessary invasive procedures should beavoided in the affected extremity. Pink wristbands can be used to indicateany other diagnosis that results in a restricted extremity.
38
Color Coded WristbandStandardization in MinnesotaLatex Allergy
Recommendation - Green for Latex Allergy
1. Why Green?
When a patient has this color-coded wristband, it
indicates an allergic reaction to latex. This green
wristband will alert the doctors, nurses, and other
health care professionals about latex allergies
Allergies
Color Coded WristbandStandardization in Minnesota
WorkPlan
Color Coded WristbandStandardization in MinnesotaSample Work Plan Document
Color Coded WristbandStandardization in MinnesotaSample Task Chart
Color Coded WristbandStandardization in Minnesota
StaffEducation
Tools
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaStaff Education
Tools for Staff Education:
Poster announcing the training meeting dates/timesStaff Sign-In SheetStaff competency check listTri-fold Staff education brochure about this initiativeFAQsTri-fold Patient education brochure about color codedwristbandsPowerPoint presentation
39
Color Coded WristbandStandardization in MinnesotaStaff Education
Color Coded Alert Wristbands / RiskReduction Strategies
A Quick Reference Card====================================
1. Use wristbands with the alert message pre-printed(such as DNR )
2. Remove any social cause colored wristbands (suchas Live Strong )
3. Remove wristbands that have been applied fromanother facility.
Color Coded WristbandStandardization in MinnesotaStaff Education
Color Coded Alert Wristbands / RiskReduction Strategies
A Quick Reference Card===================================
4. Initiate banding upon admission, changes in condition, orwhen information is received during hospital stay.
5. Educate patients and family members regarding thewristbands
6. Coordinate chart/ white board/care plan/door signageinformation/stickers with same color coding
7. Educate staff to verify patient color coded alert armbands upon assessment, hand- off of care and facilitytransfer communication.
www.mnhospitals.org
Why have a Script for Staff?
1. We know how we say something is as important as what we say. This
provides a script sheet so staff can work on the how as well as the
what.
2. Serves as an aid to help staff be comfortable when discussing the topic
of a DNR wristband.
3. Promotes patient / family involvement and reminds the patient/family
to alert staff is information is not correct.
4. By following a script, patients and families receive consistent
message which helps with retention of the information.
5. Patient Education brochure also available for staff to hand out.
Color Coded WristbandStandardization in MinnesotaStaff Education
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaStaff Education
SCRIPT for any staff person talking to a patient or family
What is a Color Coded Alert Wristband?Color coded alert wristbands are used in hospitals to quicklycommunicate a certain health care status, condition, or an alertthat a patient may have. This is done so every staff member canprovide the best care possible.
What do the colors mean?There are five different color coded alert wristbands that we aregoing to discuss because they are the most commonly ones used.
~ continued on next slide~
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaStaff Education
SCRIPT for any staff person talking to a patient or family
RED means ALLERGY ALERTIf a patient has an allergy to anything - food, medicine, dust, grass, pethair, ANYTHING- tell us. It may not seem important to you but it couldbe very important in the care the patient receives.
YELLOW means FALL RISKWe want to prevent falls at all times. Nurses assess patients all the timeto determine if they need extra attention in order to prevent a fall.Sometimes, a person may become weakened during their illness orbecause they just had a surgery. When a patient has this color codedalert wristband, the nurse is indicating this person needs to be closelymonitored because they could fall.
~ continued on next slide~
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaStaff Education
SCRIPT for any staff person talking to a patient or family
PURPLE means DNR Or Do Not Resuscitate
Some patients have expressed an end-of-life wish and we want to honor that.
PINK means Restricted Extremity
The provider is indicating the patient s extremity should be handled with care;other care providers are alerted to check with the nurse prior to any tests orprocedures.
GREEN means Latex Allergy
When a patient has this color-coded wristband, it indicates an allergic reactionto latex. This green wrist band will alert the doctors, nurses, and other healthcare professionals about latex allergies.
40
Color Coded WristbandStandardization in Minnesota
Policyand
Procedure
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaP&P
A template P&P has been provided.
Make modifications to it so it fits yourorganization s process and culture.
Includes a Patient Refusal to Participate inthe Wristband Process process.
www.mnhospitals.org
Color Coded WristbandStandardization in MinnesotaExcerpt from Refusal Form
The above named patient refuses to: (check what applies)
Wear color coded alert wristbands.
The benefits of the use of color coded wristbands have been explained to me bya member of the health care team. I understand the risk and benefits of the useof color coded wristbands, and despite this information, I do not give permissionfor the use of color coded wristbands in my care.
Remove Social Cause colored wristbands (like Live Strong and others).
The risks of refusing to remove the Social Cause colored wristbands havebeen explained to me by a member of the health care team. I understand that byrefusing to remove the Social Cause wristbands could cause confusion in mycare, and despite this information, I do not give permission for the removal ofthe Social Cause colored wristbands.Reason provided (if any):___________________________________________________
________________________________________________Date / Time Signature / Relationship_____________ ________________________________________________Date / Time Witness Signature / Job Title
www.mnhospitals.org
Color Coded WristbandStandardization in Minnesota
ResourcesTo access an online version of this Tool Kit go to the MHApatient safety page at: www.mnhospitals.org, click onPriority Issues, Patient Safety, then Tools. The toolkit
can be found under the 'Minnesota Wristband Color Toolkit'heading.
To access the Pennsylvania Patient Safety Advisory reportgo to:http://www.psa.state.pa.us/psa/lib/psa/advisories/v2_s2_sup__advisory_dec_14_2005.pdf
Questions? [Add facility-specific contact information here]
Color-coded Wristband Standardization in Minnesota
41
“Patient safety is a top priority”
Work Plan —How to Implement
ALLERGY
DNR
FALL RISK
RESTRICTEDEXTREMITY
LATEXALLERGY
Color-coded Wristband Standardization in Minnesota
42
“Patient safety is a top priority”
Suggested Work Plan for Facility Preparation, Staff Education and Patient Education
Area #1
Organizational ApprovalSee Task Chart for specific steps
Review
Adopting this initiative may need approval by appropriate committees, such as:~ Patient Safety Committee ~ Medical Staff Committee
~ Quality Improvement Council ~ Board of Directors
Action Plan
Organizations have different committees that need to approve system-wide changes, or changes that directly impact patient care. Each organization needs to assess which committees need to approve the adoption of the initiative and begin to get on meeting agendas for approval. For some organizations this may mean simply presentation at one committee, such as the Patient Safety Committee. Other organizations would need to have this approved by several committees, depending on their culture.
Consider the stakeholders and be sure they approve and understand the initiative before it is implemented so they can support it.
Area #2
Supplies Assessment and PurchaseSee Task Chart for specific steps
Review
Assessment of current supply Wristband procurement
Action Plan
Most organizations have a vendor they are using for wristbands. Most vendors are aware of the initiative and what bands should be ordered. However, if they do not know, inform them of the colors and the alert message needs to be printed directly on the wristband (please see “Vendor Information” section). They do need some lead time for the imprinting (about 2-3 weeks).
Coordinate with your Materials Management department to evaluate when current stock will be used up. Once this is known, the rest of the implementation plan will “back fill” into this date.
Coordinate with your Materials Management department to evaluate when current stock will be used up. Once this is known, the rest of the implementation plan will “back fill” into this date.
Color-coded Wristband Standardization in Minnesota
43
“Patient safety is a top priority”
Area #3
Hospital Specific Documentation
Review
Policy adoption Assessment Revision Forms revised to meet standards Consents
Action Plan
Color-banding policy should be reviewed and approved if changes are made.
Hospitals should review their respective forms for possible modifications (pt. education assessments, etc.). You may want to include language that the patient received the wristband education brochure (See Patient Education section).
If a patient refuses to wear a wristband, do you have a document indicating this? Perhaps this needs to be discussed at P&P committee. A sample has been provided in this toolkit.
Coordinate with: Risk Management Staff and individual Hospital Administrators
Area #4
Staff and Patient Orientation, Education and Training
Review
Schedule/training content Documentation requirement Posters & FAQs
Action Plan
Education format and training materials need to be reviewed.
Competency content and format has been standardized. The competency form may be individualized for the hospital.
Hospital staff education will need to be scheduled, completed and documented per hospital policy.
Make changes to the New Employee Orientation so they are provided current information.
Coordinate with: Individual Hospital Education Staff
Suggested Work Plan for Facility Preparation, Staff Education and Patient Education continued
Color-coded Wristband Standardization in Minnesota
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“Patient safety is a top priority”
Suggested Task Chart for Facility Preparation
Task Chart for Facility Preparation
Area #1 Organizational Approval & AwarenessSTEP 1 When: WEEK ONE enter date this is done:___________
What to Do Notes / Comments / Follow-upsFind out who the staff person is who supports the following committee meetings. Get the contact info for each one:~ Patient Safety Committee~ Medical Staff Committee~ Nursing Practice Council~ Quality Improvement Council~ Board of Directors~ Other?
NOTE: Not all committees will need to approve this initiative however; they will usually benefit from a presentation that provides the information about this initiative so they can support it. Seek guidance from your Administrative team to determine which meetings this needs to be presented to.
Committee Name Email / ext.
Patient Safety Comm.
Medical Staff Comm.
Nursing Practice Council
Quality Improvement Council
Board of Directors
Other
Other
Other
STEP 2 When: WEEK ONEWhat to Do Notes / Comments / Follow-ups
Find out when the next meetings are and get on agenda to present the initiative for purpose of acquiring approval or conveying information.
NOTE: Not all committees will need to approve this initiative however, they will usually benefit from a presentation that provides the information about this initiative so they can support it. This is equally important and should be considered a priority as well.
Committee Date of Next Meeting On Agenda? (Y / N)
Patient Safety Comm.
Medical Staff Comm.
Nursing Practice Council
Quality Improvement Council
Board of Directors
Other
Other
Other
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Task Chart for Facility Preparation
Area #1 Organizational Approval & Awareness continued
STEP 3 When: Pending Committee ApprovalsWhat to Do Notes / Comments / Follow-ups
After presentations made and approval obtained to adopt recommendations, contact pertinent department/staff to move forward, convey appropriate information.
Dept. Info to be Conveyed Follow-ups
Materials Management
1. Approvals obtained.
2. OK to order wristbands.
3. When will bands be available? Take that date and add 5-7 more days – that is your “Go Live” date. (The 5-7 more days are added to allow for distribution of wristbands to pertinent areas.)
How long until delivery?
Staff Education
1. Wristbands will be arriving in about _________ weeks.
2. “Go Live” Date is _______ weeks.
3. OK to start education.
Risk Management and/or QI Director
1. Wristbands will be arriving in about ________ weeks.
2. “Go Live” date is _______ weeks.
3. Confirm P&P has been approved and prepare to add to P&P manual.
Other Departments to consider:
Medical Staff, Admitting, ED, Peri-Op, Nursing, Lab, Dietary, Laboratory, Radiology, Pharmacy, etc.
1. Wristbands will be arriving in about ________ weeks.
2. “Go Live” Date is _______ weeks.
3. OK to start education. Coordinate with Education department for either materials / training / or information.
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“Patient safety is a top priority”
Task Chart for Facility Preparation
Area #1 Organizational Approval & Awareness continued
STEP 4 If any other steps required, add them here.What to Do Notes / Comments / Follow-ups
STEP 5 If any other steps required, add them here.What to Do Notes / Comments / Follow-ups
STEP 6 If any other steps required, add them here.What to Do Notes / Comments / Follow-ups
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“Patient safety is a top priority”
Task Chart for Facility Preparation
Area #2 Supplies Assessment and PurchaseSTEP 1 When: WEEK ONE enter date this is done:___________
What to Do Other Notes / CuesContact Materials Manager and brief on the initiative. Answer questions and share the toolkit.
Remember: You are just gathering information. Do not order wristbands until organizational approval has been obtained.
Coordinated with Materials Management (MM) person who will do the ordering.
MM Name: ______________________________________________________
Email: __________________________________________________________
Phone: _________________________________________________________
STEP 2 When: WEEK ONEWhat to Do Other Notes / Cues
Ask Materials Manager when current supply of wristbands will run out. This is based on estimates from typical order patterns and staff usage.
Allergy Bands run out about ______________________ (ex: mid-Jan. 08)
Fall Bands run out about ______________________
DNR Bands run out about ______________________
Restricted Extremity Bands run out about ______________________
Latex Allergy Bands run out about ______________________
STEP 3 When: WEEK ONEWhat to Do Other Notes / Cues
Ask Materials Manager to contact wristband vendor and alert them to change in supply color. Convey info to the right. Check off items once communicated to Vendor.
ALLERGY Wristband:£ Red: PMS 1788£ “ALLERGY” pre-printed on wristband in black – 48 pt. Arial Bold, all caps
FALL Wristband:£ Yellow: PMS 102 £ “FALL RISK” pre-printed on wristband in black – 48 pt. Arial Bold, all caps
DNR Wristband:£ Purple: PMS 254£ “DNR” pre-printed on wristband in white – 48 pt. Arial Bold, all caps
RESTRICTED EXTREMITY Wristband:£ Pink: PMS 1905
£ “RESTRICTED EXTREMITY” pre-printed on wristband in black – 28 pt. Arial Bold, all caps
LATEX ALLERGY Wristband:£ Green: Pantone Green
£ “LATEX ALLERGY” pre-printed on wristband in black – 28 pt. Arial Bold, all caps
Color-coded Wristband Standardization in Minnesota
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Task Chart for Facility Preparation
Area #2 Supplies Assessment and Purchase continued
STEP 4 When: WEEK TWOWhat to Do Other Notes / Cues
Follow-up with MM in a week and validate that they were able to contact vendor.
Complete info in right column from MM.
Lead time required when ordering wristbands is:
ALLERGY Wristband: ________ weeks
FALL Wristband: ________ weeks
DNR Wristband: ________ weeks
RESTRICTED EXTREMITY Wristband: ________ weeks
LATEX ALLERGY Wristband: ________ weeks
STEP 5What to Do When to Do It Other Notes / Cues
Assure Materials Management staff that you will contact them to order wristbands once organizational approval has been obtained and policy and procedure changes have been approved.
Give status report within a month of initial contact so MM knows this is still being worked on.
STEP 6 If any other steps required, add them here.
What to Do When to Do It Other Notes / Cues
STEP 7 If any other steps required, add them here.
What to Do When to Do It Other Notes / Cues
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Task Chart for Facility Preparation
Area #3 Hospital Specific DocumentationSTEP 1 When: WEEK TWO or THREE enter date this is done:___________
What to Do Other Notes and CuesContact chief nursing officer and clinical directors to review if documentation records contain specific information about wristbands, such as daily nursing charting.
Remember: This is not a recommendation to add “wristbands” to your documentation process or color specific information, but to review your current documents / process.
Coordinate with chief nursing officer and clinical directors
It may be helpful or more efficient for you to pull the daily documentation information for the various areas and review the current requirement. Consider these documents:
ED Triage record or Treatment / ED Nurses Notes
Admitting Assessment
ICU Nurses Notes
Peri-Op Assessments / Notes
Daily Nursing Documentation
Other:________________________________________________
STEP 2 When: WEEK TWO or THREEWhat to Do Other Notes and Cues
If your current documentation addresses wristband information, review documents to assure any reference to colors are updated to reflect these changes.
Again, this is not a recommendation that the documentation reflect color information about wristbands. However, if your documentation is color specific, this is a cue to validate that the information be updated to reflect the new colors – if that is your current process.
STEP 3 When: WEEK THREE or FOURWhat to Do Other Notes and Cues
If changes are required to the documentation forms, contact Forms Committee and pertinent clinical directors and initiate process for changes.
Some organizations require any changes to forms be reviewed through a “Forms Committee” or similar entity. Other organizations do not require this process if the information being changed is minimal and does not change “content.” This step is to determine your organization’s process.
STEP 4 When: WEEK THREE or FOURWhat to Do Other Notes and Cues
Once process is known, and if a form(s) update is required, factor the print time and new form availability into the time line so the education and implementation processes are in sync with the arrival of new documents.
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Task Chart for Facility Preparation
Area #3 Hospital Specific Documentation continued
STEP 5 When: WEEK FOURWhat to Do Other Notes and Cues
The Policy and Procedure for wristband application needs to be reviewed and updated to reflect the new process.
Obtain a copy of the current wristband P&P and review content.
A sample P&P has been provided for you to use as a template. Review this sample and adopt its content as it makes sense in your organization.
NOTE: It is important that you compare your current process with the sample P&P and determine what elements you will change. The sample P&P is not prescriptive but rather suggestive.
STEP 6 When: WEEK FOURWhat to Do Other Notes and Cues
Some banding processes may vary slightly within the organization given the area of care and its unique needs, such as ED, Peri-Operative, Radiology, L&D, etc. You will want to contact the directors of each of these areas and ask if they have their own P&P for banding a patient, or do they use the facility wide P&P. If they have a unique P&P, obtain a copy of it so you can compare its content with the facility-wide P&P.
Review with each area that has a unique P&P their current P&P and the proposed changes.
Contact ED Director. Name/ext: ______________________________
Unique P&P? No________ Yes________ (obtain copy)
Contact Peri-Op Director. Name/ext: __________________________
Unique P&P? No________ Yes________ (obtain copy)
Contact Radiology Director. Name/ext: ________________________
Unique P&P? No________ Yes________ (obtain copy)
Contact L&D Director. Name/ext: _____________________________
Unique P&P? No________ Yes________ (obtain copy)
Contact “other” Director. Name/ext: __________________________
Unique P&P? No________ Yes________ (obtain copy)
Contact “other” Director. Name/ext: __________________________
Unique P&P? No________ Yes________ (obtain copy)
STEP 7What to Do Other Notes and Cues
Get this item on P&P committee agenda and have approval for the changes.
Coordinate this with the departments that have “unique” P&Ps so all are changed at the same time.
P&P Committee Contact / ext. _________________________________
Date / Month on P&P Committee _______________________________
Communicate the P&P Committee date to other pertinent directors so the proposed changes are reviewed and agreed upon before P&P Committee date.
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Task Chart for Facility Preparation
Area #3 Hospital Specific Documentation continued
STEP 8 If any other steps required, add them here.What to Do Other Notes and Cues
STEP 9 If any other steps required, add them here.What to Do Other Notes and Cues
STEP 10 If any other steps required, add them here.What to Do Other Notes and Cues
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“Patient safety is a top priority”
Task Chart for Staff / Patient Education
Area #4 Staff and Patient EducationSTEP 1 When: TWO to THREE weeks
What to Do Other Notes and CuesFamiliarize yourself with training content and the tools (FAQs, brochures, Posters & more).
Review the contents of the Education session in this toolkit. This is important because as discussions occur about who will do what, you can inform directors about the tools that are available for staff to use. Because the Education section is so comprehensive, some may opt to participate in the facilitation process. By giving the directors all of the information about the tools and training section in this manual, they can make a better and informed decision.
STEP 2 When: TWO to THREE weeksWhat to Do Other Notes and Cues
Determine the education format by discussing with the Education Department and clinical directors. By education format we refer to the way the education is going to be managed - at the unit specific level or in a general session where multiple departments are present. Also, is the education going to be facilitated through the department specific directors or Education Department?
It is important to consider all of the stakeholders: physicians, dietary, pharmacy, therapies, radiology, peri-Op, ED, L&D, housekeeping, etc. The column on the right is a tool that you will need for all of the stakeholders. Use the back of this if more room is needed.
Education Dept. preferences are: _____ Unit Specific _____ General session
_____ Other (explain _____________________________________________)
Facilitator Preferences: _____ Unit Based _____ Educ Dept.
Critical Care Dir. preferences are: _____ Unit Specific _____ General session
_____ Other (explain _____________________________________________)
Facilitator Preferences: _____ Unit Based _____ Educ Dept.
Med / Surg Dir. preferences are: ____ Unit Specific _____ General session
_____ Other (explain _____________________________________________)
Facilitator Preferences: _____ Unit Based _____ Educ Dept.
Pharmacy Dir. preferences are: _____ Unit Specific _____ General session
_____ Other (explain _____________________________________________)
STEP 3 When: THREE to FOUR weeksWhat to Do Other Notes and Cues
Obtain the names of the trainers and send an email advising of an upcoming Train the Trainer. This meeting should be no longer than 45 minutes to one hour. Schedule this about one month out to accommodate already full schedules.
Whether training occurs at a unit based level or in a general session, a Train the Trainer session ought to be considered so the Education Materials and Training Tips can be viewed by all.
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Task Chart for Staff / Patient Education
Area #4 Staff and Patient Education continued
STEP 4 When: THREE to FOUR weeksWhat to Do Other Notes and Cues
Find out the name of Chair of the “Patient / Community Education” Committee. Contact that person and schedule appointment to review the patient brochure. If necessary, get on the agenda of the next committee meeting to get approval for the brochure to be used.
Another component to the education section is the patient education. Most organizations have a “Patient / Community Education” Committee that reviews education materials before it can be given to patients.
STEP 5 When: TWO weeks before Train the Trainer SessionWhat to Do Other Notes and Cues
Make one copy of the Education section of this toolkit for each trainer so they each have their own set of materials. Don’t forget about the PowerPoint presentation too. Some organizations may want to put the PowerPoint on a shared drive, while others may want to burn a copy of the CD.
Go to MHA’s web site at www.mnhospitals.org. Click on “Priority Issues,” “Patient Safety,” then “Tools.” The toolkit can be found under the “Minnesota Wristband Color Toolkit” heading.
STEP 6 When: THREE weeks before Staff Education Roll-outWhat to Do Other Notes and Cues
Send out a reminder email to all trainers reminding them to make copies of the following hand outs for their staff:
~ Staff education brochure
~ Patient education brochure
~ FAQs
~ Posters announcing the meeting (there are three to choose from)
~ Sign-in sheet
~ Competency check list (if you are using that)
It may be useful to obtain the actual wristbands to show staff exactly what they look like. Also, try to incorporate some fun into this by using purple, red, yellow and pink “props” or candy – like M&Ms, Skittles or other such things.
STEP 7 If any other steps required, add them here.What to Do Other Notes and Cues
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Acknowledgements
MHA Wristband Task Force
MHA would like to acknowledge the contributions of the MHA Patient Safety Committee and the MHA Wristband Task Force:
You may access the online information at www.mnhospitals.org. Click on “Priority Issues,” “Patient Safety,” then “Tools.” The toolkit can be found under the “Minnesota Wristband Color Toolkit” heading.
MHA would like to acknowledge three states that were instrumental in Minnesota’s wristband model:
• The Pennsylvania Color of Safety Task Force, and its early recognition of the need for wristband standardization and leadership in addressing this important issue.
• The Ohio Patient Safety Institute and their strategy to reduce or eliminate the use of wristbands.
• The Arizona Hospital and Healthcare Association and its implementation toolkit. Their expertise on the topic and support was instrumental with the development of this toolkit.
Other states wishing to reproduce this publication, please contact:
Barb Averyt, Program Director, Safe and SoundArizona Hospital and Healthcare Association, 2901 N. Central Ave, Suite 900, Phoenix, AZ 85012Phone: 602-445-4321 Email: [email protected] Web: http://www.azhha.org/public/quality
Sponsorship
We also want to thank The St. John Companies, Inc. for their generous sponsorship in this endeavor. If you would like to contact our sponsor, please direct your inquiry to:
Karen Joseph, Senior Product Manager – Patient Identification / Patient SafetyThe St. John Companies, Inc., 25167 Anza Drive, Valencia, CA 91355Phone: 800-435-4242 x 448 Fax: 661-257-2587 Email: [email protected]: www.stjohninc.com www.patientIDexpert.com
Stephanie Lach, Regions Hospital, St. Paul
Nora Vernon, Fairview Health Services, Minneapolis
Tana Casper, Grand Itasca Clinic & Hospital, Grand Rapids
Mary Buhl, St. Cloud Hospital
Special contributions from Sarah Henrickson,Human Factors-Quality Improvement Analyst Mayo Clinic Rochester
Kristine Davis, North Memorial Medical Center, Robbinsdale
Jacqueline Attlesey Pries, Mayo Clinic, Rochester
Jo Marcum, St. Joseph’s Medical Center, Brainerd
Cindy Warta, St. Joseph’s Medical Center, Brainerd
Tania Daniels, Minnesota Hospital Association (MHA)Phone: (651) 641-1121Email: [email protected]
Color-coded Wristband Standardization in Minnesota
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“Patient safety is a top priority”
Wristband Product Order Information
Most providers belong to a Group Purchasing Organization (GPO) that your Materials Management department works with. In order for the colors of the wristbands to match from facility to facility, the vendor of choice will need the following information:
Wristband Type Color Specifications Text Specifications Font Style and Size
Allergy Wristband Red — PMS 1788 “ALLERGY” in BlackArial Bold,
48 pt. All Caps
Fall Risk Wristband Yellow — PMS 102 “FALL RISK” in BlackArial Bold,
48 pt. All Caps
DNR Wristband Purple — PMS 254 “DNR” in WhiteArial Bold,
48 pt. All Caps
Restricted Extremity Wristband
Pink — PMS 1905“RESTRICTED EXTREMITY”
in BlackArial Bold,
28 pt. All Caps
Latex Allergy Wristband Green — Pantone Green“LATEX ALLERGY”
in BlackArial Bold,
28 pt. All Caps
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“Patient safety is a top priority”
Vendor Information continued
Vendor Alert Wristbands Part Number Details
The St. John Companies 25167 Anza Drive Valencia, CA 91355
Karen JosephSenior Product Manager – Patient Identification /
Patient Safety
800-435-4242 Fax: 661-257-2587 www.patientIDexpert.com
AllergyRed — WBCALA-5 Red Narrow — WBCNAA-5 Your complete source for patient identification.
The St. John Companies, Inc. is at the forefront of the standardization efforts to ensure clear patient identification and patient safety.
St. John’s products meet the recommendations for standardization in Minnesota. The following states have already implemented their color-coding initiatives and have chosen St. John as their patient ID partner: Arizona, California, Colorado, Kansas, Missouri, Nevada, New Mexico, Oregon, Utah and Wyoming.
Fall RiskYellow — WBCFRA-3Yellow Narrow — WBCNFA-3
DNRPurple — WBCDNA-8Purple Narrow — WBCNDA-13Purple Dove — WBCDVA-13
Restricted ExtremityPink — WBCREA-7Pink Narrow — WBCREA-7
Latex AllergyGreen — WBCLAA-10Green Narrow — WBCCNXA-10
Patient Identification Customization available
Standard RegisterP.O. Box 1167 Dayton, OH 45401-1167
Sherry Bannister, Label Product Marketing Manager
937-221-1299 office 800-755-6405www.standardregister.com
Allergy
Fall Risk
Patient Identification
Specializing in custom wristband solutions to address every hospitals’ needs.
Specializing in customized Training/Education Solutions (kits, binders, posters, reference cards, brochures, magnets etc.) to deliver up-to-date materials when and where you need them.
EndurID360 Merrimack Street, Building 9 Lawrence, MA 01843
Robert Chadwick, President
866-372-6585 Fax: 978-686-9710 www.endurid.com
Allergy
Fall Risk
Patient Identification
Multiple choices available White laser printable wristband which can then be color-coded with any desired color using color laser printers.
Posey5635 Peck RoadArcadia, CA 91006 800-447-6739
Jim Minda, District Manager
412-779-6667 [email protected]
Allergy Red 6247R — Embossed with “Allergy”
Fall Risk Yellow 6247Y — Embossed with “Fall Risk”
Patient Identification
PDC (Precision Dynamics Corporation) 13880 Del Sur Street San Fernando, CA 91340
Marilin Miller, SE Regional Sales Manager
800-847-0670 x 5150 www.pdccorp.com
Allergy Multiple choices available — Embossed with “Allergy”
Fall Risk Multiple choices available — Embossed with “Fall Risk”
Patient Identification Multiple choices available
Color-coded Wristband Standardization in Minnesota
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“Patient safety is a top priority”
The St. John Companies
ALLERGY
DNR
FALL RISK
RESTRICTEDEXTREMITY
LATEXALLERGY
58
Your Complete Source for Patient Identification Solutions!
For a complete selection of
patient identification wristbands,
including bar codable thermal and
laser products, visit us online at
www.patientIDexpert.com
Consolidate your admit and alert wristbands “In-A-Snap™!”
Patient Identification Wristbands
Conf entID ™
The St. John Companies, Inc., an established leader in patient identification and patient safety products for the healthcare industry, was founded in 1956.
During the past 50 years, St. John has since become one of the leading manufacturers and distributors of Patient Identification, Healthcare Labels, Medical Imaging, and Medical Records products to thousands of U.S. hospitals and Alternate Care facilities.
Our Patient Identification Systems include:• Admission Wristbands• Alert Wristbands & Clasps• Blood ID Wristbands• Labor & Delivery Wristbands• Pediatric Wristbands• Disaster Response Wristbands• Emergency Room Wristbands
Healthcare facilities use color-coded wristbands to indicate special needs, precautions and warnings that can assist caregivers to quickly assess treatment requirements. Because of concerns about lack of standardization for colored alerts, many organizations – both regional and national – have embarked on efforts to create standards for color usage on alert wristbands.
The St. John Companies is at the forefront of the standardization efforts to ensure clear patient identification and improve patient safety.
St. John’s products meet the recommendations for standardization in Minnesota. The following states have already implemented their color-coding initiatives and have chosen St. John as their Patient ID partner: Arizona, California, Colorado, Kansas, Missouri, Nevada, New Mexico, Oregon, Utah and Wyoming.
LATEXALLERGY
RESTRICTEDEXTREMITY
FALL RISK
DNR
ALLERGY
ONLINE: www.stjohninc.com • www.patientIDexpert.com • PHONE: 800.435.4242FAX: 800.321.4409 • EDI: via GHX • ADDRESS: 25167 Anza Drive, Valencia, California 91355
LATEX ALLERGY
RESTRICTED EXTREMITY
FALL RISK
DNR
ALLERGY
Comply with your state color standardization
initiative!
Reduce errors and improve patient safety.
Alerts can be added to the strap of any snap closure wristbands!
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Available Imprints:
- Allergy- Diabetic- DNR- Dysphagia- Fall Risk- Isolation
- Limb Alert- LMTD Code- Name Alert- No Blood- No Latex- Swallow
Available Colors:
ORANGE YELLOW
PINK PURPLE
CLEAR BLUE
GREEN RED
Customization available, call for more information.
Reduce confusion by eliminating multiple wristbands
Our proprietary, innovative In-A-Snap™ colored alert clasp allows you to consolidate multiple wristbands while ensuring that critical alert information is visible and easily seen and understood by caregivers. In-A-Snap™ colored alert clasps can be color coded and, if desired, imprinted with the specific alert.
Communicate multiple alerts on a single consolidated wristband easily and effectively with In-A-Snap’s™ unique interleaving design.
In-A-Snap™ colored alert clasps work with a wide variety of St. John Conf-ID-ent™ patient identification wristbands.
Whether you choose to use colored alert wristbands special alert labels, or want to find a primary identification wristband that can be color coded, St. John is committed to helping you achieve your patient safety goals.
ONLINE: www.stjohninc.com • www.patientIDexpert.com • PHONE: 800.435.4242FAX: 800.321.4409 • EDI: via GHX • ADDRESS: 25167 Anza Drive, Valencia, California 91355
Consolidate your admit and alert wristbands “In-A-Snap™!”
In-A-Snap™ Colored Alert Clasps
In 2005, The St. John Companies broadened its offering of patient identification solutions with the acquisition of Bio-Logics Products. The only wristband manufactured to incorporate the concept of “24/7 Patient Identification” and consolidate multiple wristbands for improved patient safety. This innovative solution provides the ability to immediately re-band patients at bedside, increasing patient safety and ensuring
proper identification during their entire stay.
The Bio-Logics patient identification solution gives users the ability to combine admissions, alerts (using labels or In-A-Snap™) and blood ID into one wristband for a safer and more cost effective solution.
Bio-Logics
60
Our patient safety experts will work with you to determine the best way to ensure clear patient identification and patient safety. If you don’t see a solution that meets your needs, we’ll be happy to customize one for you.
Choose from the largest selection of wristband materials, colors, sizes and closures for:
c a t i o n S y s t e mder: Call (800) 435-4242
D N RALLERGYFALL RISK
05/14/1950 56MDR: W. FRIENDLY
• Laser Wristbands
Blood Identification Wristbands
Labor and DeliveryWristbands
NICU Wristbands
Disaster PreparednessWristbands
Emergency RoomWristbands
The largest selection of patient identification solutions anywhere
ONLINE: www.stjohninc.com • www.patientIDexpert.com • PHONE: 800.435.4242FAX: 800.321.4409 • EDI: via GHX • ADDRESS: 25167 Anza Drive, Valencia, California 91355
For a complete selection of patient identification wristbands, visit us online at www.patientIDexpert.com
Conf entID ™
Patient Identification Wristbands are:Easy-to-use Cost-Effective Customizable
DNR
ALLERGY
FALL RISK
RESTRICTEDEXTREMITY
LATEXALLERGY
Admission Wristbands
• Imprint Wristbands
• Insert Wristbands
• Write-On Wristbands(Also available with clearprotective covering)
• Tyvek® Wristbands
• Thermal Wristbands (Available with clasp or adhesive closure)
Alert Wristbands
• DNR
• Allergy
• Fall Risk
• RestrictedExtremity
• Latex Allergy
• Other alert wristbands available
Tyvek® is a registered trademark of DuPont™.
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When technology matters and you are ready to add a bar code
Conf-ID-ent™ Laser Bar Code Wristbands and Chart Labels
We offer the largest variety of laser wristband layouts that work with a wide variety of laser printers. Choose from a single wristband layout with or without chart labels.
Standard features include a clear fold over laminating shield to protect the integrity of the bar code, water resistant materials to reduce smearing, and pattern adhesive to reduce oozing adhesive that may cause printer jams.
Optional tamper evident closure and punched holes for filing in the patients chart are also available.
Soft Band™ Laser Wristbands
Soft Band™ laser wristbands are a patient identification choice that is perfect for your most sensitive patients’ skin. Soft Band™ is made of a resilient, super soft, fabric material that is extra strong while maintaining skin integrity. With its flat surface the Soft Band™ is easy to scan, with great first time scan rates. Available with a tamper evident adhesive or an exclusive tamper proof clasp closure. The unique design of Soft Band™ allows for a traditional or tag style application. Use color coded In-A-Snap™ alert clasps to consolidate alerts into one wristband, increasing patient safety and comfort while reducing the cost of multiple wristbands.
PHONE: (800) 435-4242FAX: (800) 321-4409
ONLINE: www.stjohninc.comONLINE: www.patientidexpert.com
Patient Identification
Technology by
Reorder No. WBWSFT1
POP UP & PEEL
PATENT PENDING
TM
Position band with exposedadhesive face up resting oninside of patient's wrist.Do not remove backing onthe adhesive area.
1
1
2 Wrap strap around wristand adhere.
2
3
3 Check for a comfortablefit and fold over to seal.
The band is now fastened.
Bracelet style adhesive closure
4 4
Position strap under patient'swrist with exposed adhesiveto the side and facing up.Do not remove backing onthe adhesive area.
1
2 Wrap strap aroundwrist and adhere.
Check for a comfortablefit and fold over to seal.
The band is now fastened.
3
2
1
Tag style adhesive closure
3
44
Visit www.patientidexpert.com/Softband for detailed SoftBand assembly instructions.TM
25167 Anza Drive, Valencia, CA 91355
PATENT PENDING
Patient Identification
Technology by™
FLEX&
PEEL
PHONE: (800) 435-4242
FAX: (800) 321-4409
ONLINE: www.stjohninc.com
ONLINE: www.patientidexpert.com
Reorder No. WBWSFT2
25167 Anza Drive, Valencia, CA 91355
Visit www.patientidexpert.com/Softband to learn about In-A-Snap™ clasps for use with SoftBand™ and for detailed SoftBand™ assembly instructions.
2
1
Bracelet style clasp closure
Tag style clasp closure
1
2
Fold the wristband over to seal without
removing the backing. Wrap strap
around wrist, checking for a
comfortable fit.
Secure with In-A-Snap clasp by
placing clasp under band with post
coming up through selected hole
on the strap. Snap shut. Clasp is
secure when you hear it click.
Fold the wristband over to seal without
removing the backing. With flap off to
the side of patient’s wrist, wrap strap
around patient’s wrist, checking for a
comfortable fit.
Secure with In-A-Snap clasp by
placing clasp through selected hole
in the band’s strap. Snap shut. Clasp is
secure when you hear it click.
In-A-Snap alert clasps can be used
by attaching through holes along the
strap.
3TM
TM
TM
3 In-A-Snap alert clasps can be used
by attaching through holes along
the strap.
TM
2
3
3
21
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ONLINE: www.stjohninc.com • www.patientIDexpert.com • PHONE: 800.435.4242FAX: 800.321.4409 • EDI: via GHX • ADDRESS: 25167 Anza Drive, Valencia, California 91355
Conf-ID-ent™ ScanRite™ Thermal Bar Code Wristbands
The ScanRite™ adhesive and clasp closure wristbands offer low cost and the ease of printing with a thermal printer. A bar code printed by a laser printer can leave toner overspray resulting in unreliable scanability. A bar code printed by a thermal printer uses heat transfer to create a crisp bar code image resulting in reliable first read rates. A thermal wristband is durable, waterproof, tamper proof, cost effective, and easy to use. Use color coded In-A-Snap™ alert clasps to consolidate alerts into one wristband, increasing patient safety and comfort while reducing the cost of multiple wristbands.
• Traditional or tag style application
• Easy to scan with excellent first time scan rates
• Laser printable wristbands
• Adhesive and clasp closure available
• Super-soft cloth to prevent skin irritation
Tamper evident adhesive closure
Tamper proof clasp closure
• Laser printable wristbands
• Also available in super-soft cloth
• Thermal printable wristbands• Adhesive and clasp closures available