Continuum Health Partners hospitals, including Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital, Long Island College Hospital in Brooklyn, and the New York Eye and Ear Infirmary, are among a growing number of hospitals and healthcare systems nationwide that are moving toward the standardized color-coded alert system.
The initiative, called The Colors of Safety across the Continuum of Care, includes three nationally standardized alert conditions: red for allergies, yellow for fall risk, and purple for do not resuscitate, or DNR. Continuum added two of its own, which are standard throughout the system: pink for limb alerts and green for no blood transfusions.
The idea of color-coded armbands is nothing new, says Carmen Schmidt, RN, MSN, director of nursing education and research at Beth Israel Medical Center and St. Lukes Roosevelt Hospital Center, New York, N.Y.
“I’ve been a nurse for more than 30 years and there has always been an allergy ID band in hospitals where I’ve worked. There have been fall risk programs in place for a long time,” Schmidt says. “The [programs] are just different from place to place. They call them something different; they have different colors.”Carmen Schmidt, RN, MSN
What is different is that the national initiative aims to standardize the color coding, not only among hospitals in systems, but across the board at hospitals around the U.S.
Continuum, which, according to Schmidt, started the standardized system last June, was a pioneer with the Colors of Safety program in New York, N.Y. The decision to launch the Colors of Safety program was nurse driven, she says. It was Continuum’s nursing council that identified the national initiative while doing an evidence-based search for safety practices. The nursing council, charged with looking at nursing practice issues, is made up of nurses at all levels from all of Continuum’s facilities.
Nurses usually are the ones who distribute the armbands to patients, and to explain why they should wear them, Schmidt says. Patients have the right to refuse to wear the bands, Schmidt notes, but she knows of no one who has.
“I know there have been issues raised about confidentiality,” Jabara says. “I have never experienced that, and we’ve used [armbands] for years.”
Jabara says that patients understand the importance of the alerts, which can be lifesaving or keep hospital staff from reviving a person during an emergency whose wish is for a DNR.
While nursing is a big part of the initiative, the entire staff needs to know about it. In fact, all who come into contact with patients, including housekeeping staff, need to know what the colors stand for. If they forget, they can always read the bands, which are clearly labeled. That labeling, Schmidt explains, is key to the success of the program because it avoids confusion and helps those who might be color-blind to differentiate the bands.
Continuum hospitals use more than the armbands to alert staff about allergies, fall risk, DNR, limb, and no blood transfusion alerts. For example, to complement the yellow fall risk ID bands, patients at risk for falls wear special yellow treaded slipper socks, have round yellow labels on their charts, and yellow cardboard slips with patients’ names outside their rooms.
“We also did an enormous amount of work based on the interventions and documentation in our computer system,” Schmidt says.
Schmidt says the staff decided to add the pink limb alert band for mastectomy, dialysis, and other patients who have extremities that should not be used for blood draws, IV insertions, and other medical procedures. The green no-blood-transfusion band helps to alert staff when a patient has requested or consented to no blood transfusions for special beliefs, faith, or other reasons.
While she believes it is too early to back up her enthusiasm about the initiative with improving patient safety data, Schmidt is confident that the national program is a move in the right direction for the nation’s hospitals. Not only does it help staff quickly and easily identify people with risky medical conditions, but it eliminates the diversity from hospital to hospital.
“We have a lot of traveling nurses who come into our hospitals who are familiar with three national initiative colors because they’ve seen it in other places,” Schmidt says.