Presentation on theme: "Banding Together for Patient Safety"— Presentation transcript:
1 Banding Together for Patient Safety Wristband Standardization ProjectRISNA Cabinet on Nursing Practice2009
2 Acknowledgements CONP Members who worked on project: Cathy Duquette - ChairDenise BezilaNancy LancasterJean TaftDave ThomasSue Thomas
3 Wristband Standardization The RISNA Cabinet on Nursing Practice is recommending that all Rhode Island healthcare facilities voluntarily agree to use standardized wristband colorsColors selected are consistent with national direction
4 The ProblemIn Pennsylvania a patient was labeled incorrectly as DNR with a yellow wrist band. Clinicians nearly failed to resuscitate the patient until another nurse recognized the mistake.
5 Did You Know?In some states, acute care settings were using up to 10 different colors to designate 19 different risk factors.RI is not much different!The only color standardized in RI isPurple for Latex Allergy
6 Why Consider Statewide Adoption? Rhode Island is a small stateMany healthcare professionals work in more than one hospitalStudents rotate to many different sitesHaving standardized colors decreases potential for error and increases patient safety
7 Review of Standardization Models RISNA CONP completed a scan of state actions on Standardizing Wristband Colors as of April 2, 2008CONP scan revealed that most states are using or planning to useRED for AllergiesYELLOWfor FallsPURPLE for DNR
8 Review of Standardization Models Pennsylvania and Arizona were first states to implement wristband standardizationAs of July 2008, 35 states have already undertaken standardization projects28 have adopted the 3 recommended colors, several have adopted 2 additional colors7 have identified they are waiting for national standardizationRI was not included
9 Review of Standardization Models In September 2008 the American Hospital Association (AHA) identifiedNational standardization initiative plannedAHA efforts endorse adoption of:RED for AllergiesYELLOW for FallsPURPLE for DNR
10 Recommended Colors Allergy RED DNR PURPLE Fall Risk YELLOW Latex AllergyGREENRestrictedExtremityPINK
11 Recommended ProcessAll colored wristbands will have the precaution pre-printed on the wristbandColorless/white/clear admission identification bands have not been identified as a cause for concern, and are not included in the recommended colors discussion
13 Red for Allergy Do we write the allergies on the wristband too? No! Allergies should not be written on the wristband for a couple of reasons including:LegibilityAllergy list may changePatient chart should be the source for specifics
14 DO NOT RESUSCITATE PURPLE for Do Not Resuscitate Why not BLUE for a Code Blue?Potential for confusion – do I code or do I not code?
15 DNR 100% Hospitals in RI use code blue for a medical emergency Patient safety is about eliminating any potential for confusionCode Blue = Resuscitate PatientIf used Blue Wristband = Do Not Resuscitate
16 Purple for DNRIf using the purple band, do we still need to look in the chart?Yes! A chart should always be reviewed even if colored wristbands are used.Code designation can and does change during a patient’s stay.
17 Fall RiskYELLOW for Fall RiskThink Caution! Slow Down!
18 Fall Risk Why yellow for fall risk? Yellow has an association that implies CAUTION or SLOW DOWNAll healthcare providers want to be alert to fall risks as they can be prevented by anyone.
19 Additional ColorsA number of states have identified standardized colors for other common conditions…
20 Latex Allergy GREEN for Latex Allergy Think Environment No RI healthcare facility uses green for latex allergies
21 Latex Allergy Why GREEN for latex allergy? While purple is consistently used for latex allergy in Rhode Island, green is consistent with where the national standardization is headed.
22 Restricted ExtremityPINK for Restricted ExtremityThink
23 Introducing Change Rollout October 2008 RISNA Meeting Implementation presentation available for all participating Rhode Island facilitiesAnticipated implementation date – no later than July 1, 2009
24 Any Barriers to Implementation? Lessons learned…States already standardized have noted little staff resistanceCost has not been noted as a major barrier in either state.Education has not been noted as a barrier
25 Cabinet Recommendations Encourage voluntary participation by RI health care facilitiesContinue clear or white wristbands for patient identificationUse the wristband colors consistent with national effortsColor coded wristbands must include pre-printed alert messageEducational emphasis needed for change in PURPLE
26 Cabinet Recommendations Encourage adoption of facility policy to remove “social cause” wristbands (e.g., ‘Live Strong’) to minimize confusionConsider refusal form and cover band with white tape if patient refuses to removeFacilities should adopt policies that require the removal of colored wristbands applied at other facilities
27 Questions Allergy RED DNR PURPLE Fall Risk YELLOW Latex Allergy GREEN RestrictedExtremityPINKFor statewide implementation in RI no later than July 1, 2009
28 Current CONP Members Cathy Duquette - Chair Kathy Bergeron Janice CaianielloChristine GadboisNancy LancasterNicole PiermontChristina SokoloffJean Taft