Color Hazard

Despite what the age-old maxim suggests, more isn’t always merrier. Especially when it comes to the color-coded bracelets hospitals use to denote specific information about a patient. The popularity of colorful charity wristbands—like the signature yellow “LIVESTRONG” bands sold by cyclist Lance Armstrong’s foundation—is forcing health systems to distinguish conventional fashion from clinical information.

In 2005, a colored bracelet resulted in a near miss when staff members at a Pennsylvania hospital hesitated to revive a patient in cardiac arrest because they mistakenly believed his bracelet to mean, “do not resuscitate.” The absence of a standard industry color code heightens the confusion surrounding the kaleidoscopic accessories. When doctors and nurses see red at one facility, the meaning might differ from a neighboring hospital.

And color isn’t the only issue. “There’s also a major risk involved in the width and shape of bands being so similar,” says Julie Underhill, nurse manager in the patient safety department at Morton Plant Mease Health Care, a four-hospital system based in Clearwater, Fla. Privacy regulations add to the confusion because patient information is prohibited from being displayed on hospital-issued bracelets.

Hospitals are beginning to assess the benefits and risks of using color-coded bracelets with a greater sense of urgency. In fact, the 2005 Pennsylvania incident prompted the Pennsylvania Patient Safety Authority to conduct an in-state study of facilities’ use of wristbands, which Administrator Alan Rabinowitz says fostered discussion from hospitals around the country. But the debate has yet to lead to a consensus among industry and stakeholder groups.

Rather than wait for regulation, hospitals can take steps now to ensure safety. Underhill recommends one-on-one consultation between staff and patients. “If patients come in wearing specific bands, we let them know why we don’t want them worn and ask if they’ll remove them,” she says. “If they choose not to, we cover the bracelets up with white tape.” Addressing the issue privately also protects the integrity of the campaign a personal wristband represents. “We don’t want to risk undermining these wonderful charities,” Underhill says.

—Matt Rogers