Patient Safety Watchdog Calls For Standardised Wristbands

Nearly 3,000 hospital patients were given the wrong treatment last year because of inaccurate or confusing information on their identification wristband, according to the National Patient Safety Agency.

The results, the agency said, could be potentially devastating, especially in surgery. In one mix-up a diabetic patient was given an almost fatal dose of insulin.

The agency, a special health authority established to coordinate the reporting of patient safety incidents, has told NHS trusts to standardise both the colour and data on the bands by July next year. Its survey of 62 trusts found eight different coloured bands in use and some departments within trusts using bands of different colours to signify the same condition.

Illegible writing on bands is one cause of confusion for doctors and nurses. The agency also notes that eight of the trusts could not be identified on the returned questionnaires because of “missing or illegible information”. In the questionnaires, staff from nine trusts gave inconsistent replies to whether colour coding was used: seven responded “yes” and “no.” One said “yes” and “don’t know” and one gave all three responses. There were a small number of “don’t knows” to nearly every question. The range of colour codes was illustrated by the use of four colours in different hospitals for “risk of falls”: green, blue, yellow and orange. In others green and yellow are used to signify a confused person, and Jehovah’s Witnesses not wanting blood products can be either red or blue.

The NPSA said the bands in future should be white with black text, carrying the last name, first name, date of birth and NHS number. Trusts will have the discretion to use red bands to denote a specific risk such as an allergy or a patient who does not want to receive blood products. The words, preferably in a common sans serif typeface such as Helvetica, should be in black on a white panel.

Helen Glenister, the NPSA deputy chief executive, said: “We are issuing this advice to NHS organisations to encourage the standardisation of wristbands. This will help frontline staff who work in different NHS hospitals across England and Wales to make patient care safer. Wristbands are an important safety check in patient identification but do not take away the need for clinicians to check identification directly with patients. In cases where patients are unable to provide their own details because they are critically ill, unconscious, confused or cannot communicate, wristbands provide a vital backup.”

In Wales, the wristbands will also carry the first line of the patient’s address.

The NPSA said trusts must also “develop clear and consistent processes, set out in trust protocols, specifying which staff can produce, apply and check patient wristbands, how they should do it and what information sources they should use”.

By July 2009 bands should be made and printed at the patient’s bedside “wherever possible”.