Colour-coded wristbands confusing
=================================

* Lesley Ananny

Think of them as a form of hospital shorthand. Commonly used in American hospitals to instantly communicate conditions of patient care, colour-coded hospital wristbands were becoming the norm to signify allergies or do-not-resuscitate orders.

The problem was, in some states, as many as 6 or 7 colours were being used to indicate the same condition, so health care professionals working in multiple settings needed institutional colour charts just to do their jobs.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/180/2/161/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/180/2/161/F1)

The American Hospital Association is seeking standardization of colour-coded wristbands. Image by: Jodi Jacobson / iStockphoto.com

In a bid to constrain the proliferation and eliminate medical mix-ups, the American Hospital Association has stepped into the colour fray to simplify and streamline the range of wristband options and thus reduce the likelihood of caregiver error.

The Association has asked all hospitals to pare their list of wristbands to a bare minimum of 3: red for allergy, yellow for fall risk and purple for do not resuscitate.

Standardization of wristband colours has become essential, says American Hospital Association Vice-President Media Alicia Mitchell. “State hospital associations had already taken the lead in trying to standardize these colours. … It only made sense for us to step in and put together these voluntary guidelines.”

The situation was rapidly spiralling out of control, particularly when combined with fashion trends such as “livestrong” bracelets (yellow silicone wristbands popularized by former Tour de France cycling champion Lance Armstrong to promote cancer awareness), Mitchell adds. It can lead doctors and nurses to make incorrect conclusions about patient needs or preferences and only confuse the situation further.

Some 20 states have already indicated they will adopt the 3-colour guidelines, although many also expanded their colour palate to cover other data, such as white for patient identification or green for patients who are receiving blood products.

Canadian officials say there's no need to move with similar national standards because wristbands are rarely used in Canada as indicators of specific care needs.

“Some facilities may use a red or red-striped wristband to indicate allergies,” says Teresa Neuman, communications specialist for the Canadian Healthcare Association. “Other facilities, however, do not [use wristbands] in consideration of patient privacy and confidentiality.”

Relevant patient information, such as fall risk or do-not-resuscitate preferences, Neuman adds, is more typically indicated on patient charts in Canada.