Ohio hospitals looking to conform patients’ color-coded wristbands

By HARLAN SPECTOR

Ohio hospitals are trying to pull together on color-coded wristbands for patients, after a report said a confusing palette of colors and medical designations heightens the risk of errors.

The color red, for instance, is an allergy alert at some health-care facilities; at others, it means a patient is a fall risk. A survey reported by the Ohio Patient Safety Institute last year found state health facilities used 19 colors with 28 meanings.

“It can create a lot of confusion, particularly when caregivers move between organizations,” said Marti Bauschka, nursing chief at Southwest General Health Center in Middleburg Heights.

The move to conformity is happening all over the U.S. Authorities in Pennsylvania brought attention to the issue in 2005 when a patient nearly died because a yellow “do-not-resuscitate” bracelet was mistakenly put on the patient’s wrist.

The nurse who placed the wristband worked at another nearby hospital where yellow meant no blood draws in that arm. The patient subsequently went into cardiac arrest, and rescue efforts almost didn’t happen (the mistake was caught).

The Ohio patient-safety group, an arm of state hospital and physician associations, recommended four colors: red for allergies; yellow for fall risk; white or clear for patient identification; and green for those receiving blood products.

The Ohio Hospital Association estimates more than half of its members have converted to the new color scheme, said Rosalie Weakland, the association director of quality improvement. Others are working on it, she said.

The Cleveland Clinic, which owns most of the hospitals in Cuyahoga County, said its community hospitals are on board, and changes at the main hospital are in progress.

“This is a trend that says less is better,” said Dr. Shannon Phillips, a patient-safety officer at the Clinic. “It’s gotten a little out of hand.”

Even so, hospitals are still not marching in step when it comes to do-not-resuscitate (DNR) bracelets. The state patient-safety group did not recommend the national standard — purple — because Ohio DNR rules require the wristbands be clear with a DNR logo.

While that requirement is under review, the Clinic said it is going with purple. The Lake Hospital System uses blue. University Hospitals Case Medical Center does not use DNR wristbands unless a patient is transferring to another facility.

UH’s Dr. Michael Anderson cited concerns about the privacy of patients’ end-of-life wishes. “It seems a little awkward having a bracelet that identifies a patient as not wanting resuscitation,” he said.

As for the color choice, hospital association spokeswoman Tiffany Himmelreich said some hospitals are going with purple DNR bands. “While they recognize the state law, they feel it’s important to go with the national standard in hopes the state law catches up.”

Ultimately, the goal is to eliminate wrist bands and have alerts embedded in a bar code on hospital ID bracelets, the association said.