Title: Color-Coded Alert Wristbands Number: 3.

040

Approved by: Chief Clinical Officer Created: 05/2008 Revised/ Reviewed: 04/21,
04/16, 09/15; 8/13; 10/10; 09/09

CHRISTUS Health Clinical Policy

Page 1 of 4
I. KEY WORDS: Color-Coded, Wristbands, Armbands

II. OBJECTIVE:
To establish a consistent process that identifies and communicates patient specific risk factors or
special needs by standardizing the use of color-coded wristbands based upon the patient's
assessment, expressed requests, and medical status. The color-coded alert wristband will be a
communication tool for clinical and non-clinical staff and enable the patient/family to participate
in the promotion of patient safety.

III. POLICY STATEMENT:

All patients admitted to CHRISTUS Health hospitals, emergency rooms, and outpatient procedure
areas will have all other wristbands removed, to include those applied by other health care facilities
and/or “community” wristbands. State-sponsored emergency alert wristbands should not be
removed. All patients admitted to CHRISTUS Health hospitals, emergency rooms, and outpatient
procedures areas will have color-coded wristbands applied and maintained to identify the patient
and patient risks or states; specifically fall risk, allergies, restricted extremity, and Do Not
Resuscitate. Color-coded alert wristbands are alerts only and do not take the place of orders,
directives, or clinical judgment or communication strategies, such as hand-off communication.

IV. DEFINITIONS:
A. Color-Coded Alert Wristband: The bracelet applied to a patient used to identify certain
risks or states; specifically fall risk, do not resuscitate, allergies, or restricted extremity.
B. "Community" Wristbands: Bracelets worn by a patient to support or communicate
“social cause” interest, e.g. Yellow LIVESTRONG or Pink Breast Cancer Awareness band
and or identification/color-coded wristbands applied by other health care entities.
C. Restricted Extremity: Extremity which should not be used for blood pressure
measurement, IV insertion, or other medical procedures related to certain medical
conditions such as previous history of breast cancer, lymphedema, or vascular shunts.
D. State-sponsored emergency alert wristbands: A wristband system used to track
patient evacuated during crisis situations, usually using RFID technology enabling
emergency management personnel to track, identify, move and assist individuals
during a crisis situation. State-sponsored emergency alert wristbands should not be
removed. These wristbands may be color coded and include the State Seal embedded
in the technology. A second type of State-sponsored emergency alert wristband in the
State of Texas is the Dialysis Patient Tracking bracelet. This bracelet is distributed to
end stage renal patients to facilitate the provision of quality care to this patient group
so that an emergency will not disrupt the delivery of dialysis and transplant services.
This color-coded wristband is lavender in color and includes the text "ESRD Evacuee"
Title: Color-Coded Alert Wristbands Number: 3.040

Approved by: Chief Clinical Officer Created: 05/2008 Revised/ Reviewed: 04/21,
04/16, 09/15; 8/13; 10/10; 09/09

CHRISTUS Health Clinical Policy

Page 2 of 4
in white letters on the wristband. KEY POINT: Be cautious to distinguish between the
dark purple "DNR" hospital wristband and the lavender state-sponsored wristband
with text used by the State of Texas to identify ESRD (End Stage Renal Disease)
Evacuees.

V. PROCESS
A. Color-Coded Alert Wrist-banding:
1. The armband colors used at CHRISTUS Health will mean:
a. RED – Allergies
b. YELLOW - Fall Risk
c. PURPLE- Do Not Resuscitate (DNR)
d. PINK - Restricted Extremity
2. Additional colors recommended but not required:
a. GREEN – Recommended by Louisiana – Latex Allergy
B. Each armband will be pre-printed in large, easy-to-read, black lettering with the
words identifying the meaning of the color, with the exception of the purple
armband which will have no lettering on the armband.
C. Hospital staff should not write on the alert wristbands.
D. Wristbands will be placed on the same extremity as the Patient Identification
wristband, except for the Restricted Extremity armband which will be placed on the
extremity that should not be used.
E. Color-Coded Alert Wristbands may only be applied or removed by a nurse.
F. Colorless/Clear/White arm bands will be used for Patient Identification.

VI. RESPONSIBILITIES
A. Patient/Family/Responsible Party/Significant Other(s):
The patient/family/responsible party/significant other(s)
should:
1. Participate in education regarding the color-coded alert wristband;
2. Request patient permission to remove all "community" wristbands
and any wristbands applied by other health care facilities and give
them to the patient/family to be discarded or sent home. If the patient
chooses to continue to wear “community" wristbands or wristbands
from another facility, the nurse will document this in the patient's
record and request that those wrist bands be covered with white or
opaque medical tape for the patient’s safety;
NOTE: If a bracelet is reusable from a specialty clinic or other
healthcare provider, try to avoid discarding.
Title: Color-Coded Alert Wristbands Number: 3.040

Approved by: Chief Clinical Officer Created: 05/2008 Revised/ Reviewed: 04/21,
04/16, 09/15; 8/13; 10/10; 09/09

CHRISTUS Health Clinical Policy

Page 3 of 4
3. Do Not remove the wristbands applied by the CHRISTUS Health staff
until they return home;
4. Alert the staff if the wristband is removed or becomes damaged; and
5. Adhere to safety measures to be followed in relation to the patient's
identified risk/state.
B. Nursing/Clinical Department:
1. Upon admission to the hospital/emergency room/outpatient procedure
area, the admitting Registered Nurse will complete or review the
admission history, educate the patient and family regarding the Color-
Coded Alert Wristband policy, and, within 4 hours of admission, apply
the correct wristband(s).
2. If a patient is capable and refuses to wear the color-coded alert
wristband, the risks should be explained to the patient/family and the
healthcare staff should document the non-adherence.
3. The nurse will ensure all "community" wristbands and wristbands
applied by another facility are removed. If the patient chooses to
continue to wear the "community" wristbands or wristbands from
another facility, the nurse will document this in the patient's record.
Those wrist bands will be covered with white or opaque medical tape.
NOTE: If a bracelet is reusable from a specialty clinic or other healthcare
provider, try to avoid discarding.
4. Upon reassessment or physician order, if it is determined that a change
in health status warrants application, re-application, or removal of a
color-coded alert wristband, the nurse should apply/remove a color-
coded alert wristband.
5. At each patient handoff, the color-coded alert wristband(s) should be
reconfirmed.
C. Nursing/Clinical staff will use the color-coded alert wristbands as a communication tool
and should utilize the patient's medical record to verify allergies, fall risk, advance
directives, and extremity restrictions.
D. Admission/Pre-registration and/or Emergency Department Registration Staff: Apply
the colorless/clear/white patient identification/registration band in accordance with
organizational policy.
E. Purchasing/Materials Management: Purchasing and Materials Management will obtain
and maintain a supply of color armbands with the defined color tones (primary and
secondary colors only) which are preprinted in large, easy-to-read, black lettering with
the words defined by policy.
F. Administration: Administration is responsible for verifying and documenting that
both clinical and non-clinical staff has the appropriate supplies, orientation,
Title: Color-Coded Alert Wristbands Number: 3.040

Approved by: Chief Clinical Officer Created: 05/2008 Revised/ Reviewed: 04/21,
04/16, 09/15; 8/13; 10/10; 09/09

CHRISTUS Health Clinical Policy

Page 4 of 4
competency, and reinforcement to implement the color-coded alert wristband
protocol.

V. REGULATIONS/REQUIREMENTS:
Texas Hospital Association. Color-coded Wristband Standardization Project in Texas:
Implementation Toolkit. Distributed October, 2008. https://www.tha.org/Public-
Policy/Issues/Quality-and-Patient-Safety/Wristband-Standardization-Initiative
Louisiana Hospital Association. 2008. Color-Coded Wristband Standardization Toolkit

VI. RELATED POLICIES: 3.030 Falls Protocol

VII. REFERENCES:
American Hospital Association. Implementing standardized colors for patient alert
wristbands. Quality Advisory. Distributed September 4, 2008.
https://tcgbarcode.com/wp-content/uploads/2017/02/color-wristband-
standardization.pdf
ECRI and ISMP. Update on Use of Color-Coded Patient Wristbands. Patient Safety Advisory,
V3, Sup 1, August 9, 2006.
Watson, D. (2009, September). Standardizing wristband colors. AORN Journal, 449-52.

VIII. OFFICE OF PRIMARY RESPONSIBILITY: Clinical Excellence Services

5/21/2021
Date