Designing evidence-based patient safety interventions: the case of the UK's National Health Service hospital wristbands.

Rationale, Aims And Objectives: Current evidence suggests that hospital inpatient identification wristbands are not used optimally. Here we report a project by the National Patient Safety Agency (NPSA) to inform guidance development to hospitals regarding wristband specifications.

Method: A survey assessed (i) the information on wristbands; (ii) the processes of issuing/checking/applying wristbands onto patients; (iii) the types/designs of wristbands (including colour-coding); and (iv) the main problems faced by staff face in relation to wristbanding patients.

Results: Responses from 166 staff members from 62 hospitals in England and Wales were collected. Information: most participants reported using the patients' first and last names, their date of birth and their local hospital number. The National Health Service (NHS) number, which is a unique identifier for each patient, is used by 37% of the respondents. Issuing process: wristbands are issued on admission or at Emergency Departments. Trained or untrained staff are involved in issuing/checking/applying wristbands onto patients, without significant problems. Colour-coding: 29/36 multiple-respondent hospitals and 15/16 single-respondent hospitals use colour-coded wristbands to indicate special patient status (e.g. allergies). Colour-coding is not used consistently: four colours are used to signal risk of fall; red is used to signal at least 10 different statuses/risks.

Conclusion: The NPSA recommends that wristbands should include patient's last and first name, date of birth and NHS number. They should be printed/written in black against white background. Only red colour should be used to signal special patient status. These recommendations are consistent with current developments in patient identification, and will be evaluated.