New Color Coded Hospital Bracelets Save Lives, But Raise Privacy Concerns

Confusion about what those color coded bracelets mean can cause deadly medical mistakes, but if the bracelets are standardized — is everyone going to know your business?

The NYT has an interesting article about the movement to standardize the bracelets:

The goal is to prevent potentially dangerous mistakes, like giving the wrong food to an allergic child, or allowing a patient with balance problems to walk unescorted down a freshly waxed hallway. The drive was spurred, in part, by a notorious 2005 Pennsylvania case in which a patient nearly died because a nurse used a yellow band thinking it meant “restricted extremity” (don’t draw blood from that arm), as it did at another hospital where the nurse sometimes worked, when at this hospital it meant D.N.R.

While the new color-coding has been quickly embraced by at least 20 states and endorsed by the American Hospital Association, the purple bands, typically embossed with the letters D.N.R. to reinforce the message, are meeting with some resistance.

The nation’s leading hospital-accreditation agency, known as the Joint Commission, has expressed caution about the new system, citing concerns about branding patients by their end-of-life choices, or inadvertently broadcasting those choices to family and friends who have not been consulted.

The commission also said that children who do not understand the system had been prone to trade the wristbands like baseball cards.

Awwwwkkwaaarrrdd. The main takeaway for the consumer is that hospitals make mistakes, so it’s a good idea to ask questions about the bracelets that they put on you and make sure that everything is as it should be. If something doesn’t seem right, speak up for yourself or for your family.

Hospital Bracelets Face Hurdles as They Fix Hazard [NYT]
(Photo:Chester Higgins Jr./The New York Times)

Comments

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  1. BeeBoo says:

    There is no privacy concern, using them is optional and the patient has the choice. There are greater privacy concerns in hospitals like OR schedules on whiteboards and chart racks left in hallways.

  2. ironchef says:

    everything is within the hospital walls. Privacy is going way overboard. Besides…these tags AREN’T ATTRIBUTABLE to any particular NAME.

    • macinjosh says:

      @ironchef: But presumably they are wrapped around a particular wrist, which is attached via various body parts to an identifiable head which a person could direct words or a glance to. Like it says above, I don’t think people would want their “Do Not Resuscitate” or “Spastic Colon” status to be broadcast within eyeshot.

      • Coles_Law says:

        @macinjosh: True, but I would prefer to know if anyone near me had a spastic colon.

        According to the article, this is a non-issue for the patients-only one at the hospital in the interview had refused the bracelet for privacy concerns.

      • cadieg says:

        @macinjosh: these bands *don’t* disclose the patient’s diagnosis. they are for medical staff to be sure to super triple check that this patient IS in fact allergic to whatever. i know that as a nurse in the ER, i have had patients tell me “no, i’m not allergic to anything” when i walk in to administer a med only to tell me ten minutes later that they are IN FACT allergic to the antibiotic i just gave them. it’s a “people are stupid” safety check.

        besides, who really cares if someone else notices you have an allergy or don’t want a blood transfusion?

        • stre says:

          @cadieg: states right in the damn article that no one cares about the allergy one. it’s just the DNR one. if someone decides on their own that they do not want to be resuscitated and does not want to cause anxiety within the family by broadcasting that they’re ready to die, should they be branded with a tag showing as much?

          for most of these bracelets, everyone is gung ho about using them. it’s the DNR that incites some questions.

  3. GreatWhiteNorth says:

    Let’s have bands for the hospital staff… not all of them, just the ones who are at risk of doing something radical like cutting off a man’s penis during a circumcision. That doctor’s band should be shock orange with flashing LED’s in it warning patients about the potential of getting more than a trim!

    • GreatWhiteNorth says:

      @GreatWhiteNorth: Sorry folks… my little guy hasn’t come out since reading the earlier story about the circumcision… and it’s been hours!

      • verdantpine says:

        @GreatWhiteNorth: Yeah, I don’t blame you. I was already feeling very sympathetic (and forwarded the article to my husband…) but THEN I read the article about the woman whose stomach was removed through her vagina, over on sister blog Jezebel.

  4. RhymePhile says:

    I think the color black would be more suited to the DNR patients. Or maybe blue.

  5. zigziggityzoo says:

    If you’re wondering, I believe D.N.R. means Do Not Resuscitate.

  6. chrisjames says:

    Sounds like a cheeky solution. Like the hospitals want to hold on to their dear color-coding systems, but not have to deal with misinterpretations between systems. Hey, you have charts, machines, gadgets, and plenty of other monitoring and information systems throughout the hospital. Why should anything resolve down to bracelet scrutiny?

    Make them white, teach nurses to read.

    • BeeBoo says:

      @chrisjames: How insulting to nurses. The bracelets are just an alert. The absence of a red band would never mean “no allergies” but the presence of one means “Check the chart and ask the patient about allergies”.

      The primary error that caused the death occurred when the color of the band was chosen.

      • chrisjames says:

        @BeeBoo: That validates the point. Color-coding is causing a mix-up.

        Okay, the real problem is human error, and redundancy is always the best solution for that. However, the case implies that they’re already using the colors to circumvent the redundant information, or that it wasn’t indicated elsewhere to begin with.

        You can take all sorts of offense at the comment, but still, they must read. Take a little caution when it comes to people’s lives. Not even the urgency of crisis is excuse enough to reduce complex health issues to color.

        • BeeBoo says:

          @chrisjames: It’s not the color coding that’s causing the mix-up, it’s the lack of universal agreement on what the colors mean. Imagine if STOP signs came in yellow, red, or blue depending on what county you were in.

          Health care professionals frequently work in different settings. In an emergency situation, many of the people involved are not familiar with the patient–they are called to the scene. Having a passing pulmonologist think that a red bracelet means “no transfusions” when it really means “DNR” could cause CPR to be initiated anyway if the DNR sign had fallen off the wall and under the bed and he is wandering down the hallway and hears a patient in respiratory distress..

          And yes, in a crisis, you DO want to reduce such complex issues to color and provide instant information. That is the way to reduce error. That is why emergency exit signs are red and yellow means caution.

          The bracelets are just a visual alert system, one piece of the puzzle, and they are NEVER meant to convey the definitive instruction or information.

        • silentluciditi says:

          @chrisjames:

          The urgency of crisis demands quick and easily accessible and identifiable information. That would be the reason why they used colored tags during triage, so you can immediately tell the patient’s general status at a glance. Reading is important, and should overshadow anything else, but color is a simple and easy way to transmit information to the caregiver, but only if it is standadized throughout all practices (as this concept is meant to do).

    • innocentconsumer says:

      @chrisjames: I agree. I work in a health clinic, training our staff in how to use our electronic medical record software. It AMAZES me how many of our nurses and providers are constantly looking for a faster way to find something out instead of just READING a document to find out crucial information on a patient. Some even go so far as to say they aren’t going to update our patients’ medication lists each time they come for an appointment because it takes too long…that’s crucial information that we need to know to avoid any potentially negative interactions between drugs. The laziness is beginning to ASTOUND me.

      • My Iron Lung is Rusted says:

        @innocentconsumer & chrisjames: You’re absolutely right. The next time I rush to your side because your heart has stopped, I’ll stop by the nurses station, either pull up your electronic record or hunt down your paper chart, and use the 5-7 minutes before irreversible brain damage to do something more productive than resuscitate you. Like verify you aren’t a DNR.

      • roguemarvel says:

        @innocentconsumer: I actually had an issue with this the other day. i was in the ER because I was having an allergic reaction to God only knows what and traditional medication wasn’t working so the doctor prescribed an adrenalin shot. The nurse didn’t take the time to read the chart closely to see it was supposed to be delivered threw the muscle not the blood stream via IV. The result was one of the most painful experiences of my life. Lucky the nurse was smart enough to stay in the room with me since when they had given me medication earlier I had had a panic attack. If she hadn’t been there I probably would have had another panic attack. The doctor later found out and apologized over and over for the mistake. I don’t know if the nurse got what was going to here for the mistake tho.

  7. davere says:

    I’m allergic to Demerol, a pain killer. When I was in for surgery they put a red bracelet with the name of the medication.

    The doctor and 3 different nurses, each independently said “we’ll also give you some Demerol.” I had to keep reminding them that I am allergic to Demerol.

    • British Benzene says:

      @davere: My grandfather was allergic to penicillin and related drugs. He used to say “I don’t want to go to the hospital, they’ll kill me!”

    • Archipelago says:

      @davere: My own doctor can not even remember what I am allergic to. I have to remind him every time he gives me a prescription.

    • Tank says:

      @davere: I’m a 6’1″ 240# man, with a beard & mustache. A few years back I had a hernia surgery, the O.R. nurse asked my name, then asked what I was there for. I told her a hysterectomy. SHe ’bout crapped.

      • Elderbear says:

        @Tank: I work for a large health services deliver corporation that is almost done rolling out electronic medical records. When I trained on the s/w 18 months ago, I could order hysterectomies for men and prostate surgery for women.

        SCARY

  8. Nik in Denver, formerly in NOLA says:

    There is a small privacy concern, but I think the larger concern is the anecdote about kids trading them like trading cards. That could be a potential nightmare when the kid allergic to various antibiotics swaps the bracelet with the kid that can’t accept a blood transfusion.

  9. Corporate_guy says:

    Slap bar codes on them and give nurses a reader.

    • padams89 says:

      @Corporate_guy: the issue being that not every healthcare provider who needs to get the message is a nurse and when a pt is coding you dont want to waste time whipping out a scanner to figure out that they have an allergy to an ACLS drug.

    • Mary says:

      @Corporate_guy: I thought this was a standard by now, most hospitals I’ve been too recently have some sort of barcode on the bracelets. Not that I’ve seen anybody stop to read them, but I haven’t been an admitted patient in quite some time.

      Honestly, while I can see other flaws in the system privacy isn’t one of them for me. I would rather the staff know what they need to know, no matter what. While there are things about my medical history I wouldn’t want published in the paper, at the same time if it came down it and it was my life or my co-workers knowing I have some sort of condition, I’d choose for my life to be saved.

    • delicatedisarray says:

      @Corporate_guy: The last hospital I was at had barcodes on the wrist bands and each nurse and doctor has a scanner on their belt/in thier pocket. It didn’t seem like it was that large of an extra step to do, espically when it has to do with a patients well being.

    • Elderbear says:

      @Corporate_guy: Color codes are useful. I’m glad that a standard is being developed. Our hospital uses a different color system. When Joint Commission inspectors come on site, they ask personnel what the various colors mean.

      Having DNR on a wristband seems like overkill. That’s an item for a chart. However, the bands we use signify:

      Non-native English speaker (may speak no English), fall risk, confusion or dementia, and allergies. These are all items that may be very important it identify immediately and reveal little protected health information.

  10. pine22 says:

    i think they should use the colored ones, just not display what they mean to the public. as long as the staff knows then its ok. most hospitals use codes over the P.A. that people dont know.

    • BeeBoo says:

      @davere: Demerol is crappy anyway, primarily because of side effects. Morphine is still the standard of pain medications. Nazi scientists invented Demerol as a morphine substitute because they had difficulty getting opium poppies.

      • Elderbear says:

        @BeeBoo: Demerol can (rarely) trigger seizures and death. Our organization doesn’t use it for that reason (among others). Every once in a while somebody who drove to the ER with a migraine ended up dead from the demerol shot.

  11. MayorBee says:

    Give me privacy or give me death! Wait…Not both, I can’t make do with both!

  12. kerry says:

    I think ultimately the care of the patient should come first, so if standardizing bracelets improves the quality of care and reduces the chance for screwups I say go for it. If the patient is a DNR or has an allergy, that info is usually posted in a manner that any visitor could see, so privacy concerns are sort of moot. Also, in the case of something like family not knowing the end-of-life choices the patient has made, uh, they’re going to find out eventually. I’m just saying.

  13. British Benzene says:

    As a health & safety professional, I think these are a great idea. As has already been said, there are much bigger privacy concerns (white boards, poor chart practices).

    Also: most of the DNR and No Transfusion patients would have made a choice to do that for non-medical reasons such as personal beliefs (CoC:Scientist for the Transfusions). The only issue I would see is if someone was a DNR, but did not want some family or friends to know that (yes, it happens, guilt is a powerful thing).

  14. quail says:

    Why not put RFID chips into all of the bracelets and then give the staff powerful readers that allow them to see the patient’s medical history, needs, and credit card information from across the room.

    • nagumi says:

      @quail: Actually, I really like that idea.

    • satoru says:

      @quail: I think you’re thinking too hard about this. It would be easier to just have a bar code on people which you could scan and do a database lookup. This would be cheaper to implement for hospitals.

      The problem is that only like 5% of hospitals in the USA are on an EMR. So even if you had an awesome idea to do stuff, there is no electronic record for you to reference for data. It’s quite sad the state of IT affairs in health care. They’d still be running ccMail if Lotus still supported it :P

      • quail says:

        @satoru: I think everyone missed my sarcasm when it comes to security/privacy with RFID chips.

        ;) Ah, well. I’ll have to work on my scathing wit some more.

  15. Wahh… if someone doesn’t care about their medical condition they can always tear their armband off. If they don’t want to live but don’t mind the possibility of a concerned doctor making an effort anyway, they are welcome to tear off their wristband too.

  16. nagumi says:

    I once found out that a fellow patient I shared a room with was HIV positive because of exactly this type of thing. Luckily, I’m educated enough to know that it’s not a concern and I didn’t let the other patient find out I was aware, but what if I’d been a troublemaker?

    • British Benzene says:

      @nagumi: That also raises a concern of bias on the parts of some medical personnel. I’ve seen nurses think twice about blood when they suspected someone was HIV+. This despite all the “universal precautions” training we try to beat into them.

      • nagumi says:

        @EnglishC6H6 is British Benzene: True, though I believe her chart was clearly labelled in big letters (on a red sticker) in order to let staff know so they WOULD take extra precautions. I also found out a close friend in the ward had Hep B. She herself didn’t know, but I did because I knew what “HEPB” means on a chart. Now, I wasn’t snooping. It was in big letters on a colored sticker, meant to stand out.

        • British Benzene says:

          @nagumi: That was my point, we train to “Universal Precautions”. Which means “Always assume every bodily fluid is infectious and treat it as such.”

          I’m trying to get my people to see that Hep. C is really scary crap. I’ve also had a biologist exposed to tularemia (“Rabbit Fever”) which no one expected. HIV is not the only thing out there that should scare the crap out of people, but it’s what everyone thinks of.

          • Rectilinear Propagation says:

            I’m trying to get my people to see that Hep. C is really scary crap.

            @EnglishC6H6 is British Benzene: The only time I’ve given blood they sent me a letter telling me I had Hepatitis B. Scared the every living fool out of me until I had my blood drawn by a doctor and it turned out I didn’t have it. I’d look up stuff information on Hepatitis, panic, look up more info, panic more, then panic for the heck of it.

            I still don’t know why they thought I had it but the letter said even if someone else says I’m OK they won’t take my blood.

            • kerry says:

              @Rectilinear Propagation: This happens when you, for whatever reason, test positive for certain hepatitis B antigens. It can happen without being infected, but because it makes your blood indistinguishable from someone who is positive for hepatitis B then no blood bank can take it. If you have a rare blood type, however, you can often get a note in your file with the blood bank approving your blood for use by the director of the lab, once you’ve sufficiently proven your status as a false positive.
              If you don’t have a terribly rare blood type it’s not really worth the trouble.
              Also, the letter you received should have said that you “tested positive for a hepatitis B antigen,” which is *not* the same as saying that you are infected with anything.

          • nagumi says:

            @EnglishC6H6 is British Benzene: Yeah, exactly. That was my argument to the nurses, and they actually removed all the stickers.

  17. Eels says:

    I wish I had a job with the joint comission because I’d love to get paid TONS of money to nit pick total bullcrap while people are doing real work. Their concerns about patient confidentiality are often absurd.

  18. HogwartsAlum says:

    What bothers me is the children trading them. How would some poor overworked nurse even think to check for that?

    Also, the whole “family not consulted” thing is a potential problem. It’s bad enough now that people don’t respect your wishes, or can’t find the paperwork. My ex’s mother had a heart attack and was without oxygen long enough to cause massive brain damage before they found her. She was put on a respirator for a week expressly against her wishes because no one could find the DNR papers. One look at her, and you knew it was futile. But they had to do it.

    My family will throw a fit over my final wishes, I know. I want DNR and to donate myself to the body farm. If they don’t do it, I will haunt them.

  19. padams89 says:

    The hospital I work at uses stickers put on the pt ID bracelet to signify this type of thing for example a fall risk is a yellow smiley face sticker, that way the entire staff knows and it is not a privacy issue. We also have plasma screens that code everything we need to know about a pt via icons that makes sense but are not obvious. For example an L next to the room number indicates that the patients needs labs drawn, M, pt has new medication orders, small picture of a heart, pt needs EKG….etc. There are plenty of ways to do it, but uniformity is of utmost importanace because many providers works at a few facilities.

  20. VA_White says:

    Do they have a color that means “Don’t Cut off My Dick”??

    TJC does a lot of good work for patients. It might seem like they are nitpicking sometimes but hospitals make a frightening number of mistakes every year. When it comes to people’s lives (and penises) I don’t think it’s possible to be too picky.

    The worry over privacy but they also worry over whether you get the right treatment when you roll in the ER with chest pain.

  21. crazedhare says:

    My baby is currently inpatient, long term, being treated for cancer. She is 5 months old, and expected to be hospitalised for the next year. We have been in hospitals most of her life.

    At every hospital we’ve been to, the ID wristbands must be scanned with a 3-prong positive ID before ANY action is taken. That is, the wristband must match up, the room number must match up, and the patient (or for us, parent) must confirm the child’s name, DOB and medical number. So, the nurses DO read, TYVM, and DO take the time to be incredibly careful.

    But, think practically. Nurses have a lot of patients, urgent steps need to be taken, prioritizing needs to occur. The nurses provide great care to my little one, and anything that helps them do their job, helps my daughter heal. They can do the necessary to ensure they are treating correctly quickly, and get on to helping my baby feel better.

    Also, having spent months at children’s hospitals (including St. Jude), and spending a lot of time hanging out with kids, I have never seen them trade bracelets. Nor have I seen people eyeballing each other’s bracelets to get personal info.

  22. Triborough says:

    How about changing the whole system of doctors on call and interns and let them get the rest they need.

  23. crazedhare says:

    @padams89:
    The problem with that is that every parent/patient figures out the symbols. So it’s all the same in the end. I actually prefer symbols/colors over words because I think the reaction time would be better, don’t you?

  24. BuddhaLite says:

    This isn’t exactly a new trick. Pay attention the next time you go to your doctors office. They’ll put you in a room on outside the door they place your chart and there’s typically color coded markers they can swing out. It standardizes communications so that the Dr and nurses don’t have to verbally communicate.

    As for the bands you should be able to show them to any hospital worker that you have on and ask what they mean. If there’s confusion theres an issue. If HIPAA regulations don’t have an issue with it I’m not going to either.

  25. I hope there isn’t a patent on these…I can see the latest tween craze of wearing those bracelets…now, if I can just figure out how to make them and sell them…I could pr0fit! ;-)

  26. Mr.SithNinja says:

    If Hospitals were worried about “privacy concerns” then they would make gowns that don’t have your ass hanging out for all the world to see.

    I wonder how many patients realise that purple “DNR” braclet means “Do Not Resusitate” just before they go into cardiac arrest and try to gnaw it off.

  27. catastrophegirl chooses not to fly says:

    last time i was in the hospital they wrote my medication allergy list on the bracelet. nurses saw my arm a lot more often than they picked up my chart.
    [warning - the pic is not pretty: [farm4.static.flickr.com] ] [yes, i have a cameraphone and i was REALLY bored that day]

    on the privacy side of things? i was pretty much only able to get within a few feet of the bed unless i went over and unplugged my IV stand and walked it with me but my chart was on the wall at eye level in the doorway [an alcove sort of thing] where it was the very first thing anyone saw walking in.
    anyone could have read it from the doorway while i slept unaware. or just walked up and looked at it against my protests while i was attached to the wall via the IV.

    doesn’t make me panic. while i don’t like the government snooping into my stuff, i’d rather have a little less privacy and not have someone accidentally give me penicillin or darvocet. i have to be alive to care about my privacy

  28. SuchitaFantazmoto says:

    RhymePhile: In the field, emergency medical responders will use a black tag to denote someone as “dead, or soon to be” in major multiple casualty incidents (think: bus accident where on the scene triage is required). It’s a little macabre. Especially since the symbol on the tag is a stylized shovel/cross.

    My rather dark sense of humor enjoys it, but I’m not looking forward to slapping one of those on someone just because I can’t get an airway open. :(

  29. snoop-blog says:

    As long as they don’t say things like “herpes”, or “chlamydia”, or “gonorrhea” I think were ok.

  30. JW says:

    Why not just read the patient’s chart? That is why patients have charts, right? To tell the nurses and doctors what is going on with the patient. Why not just include all of that on the wrist band that they are already wearing? Seems less complicated. Have some kind of ONE colored sticky note stuck on the chart that has all the allergies and alerts. I like the colored band idea, but if it is going to be confusing they should think simple is better.

    • theblackdog says:

      @JeremyWayne: I think the idea behind the bands is to simplify things because in an emergency, the personnel may not have time to read the chart to find that sticky note, and let’s not forget that sticky notes can be misplaced.

    • mrsultana can't get a password to work says:

      @JeremyWayne:
      I just graduated from nursing school and I’ll tell ya, you can’t find those charts for anything!
      The doc is writing orders in them. Then the physical therapist has to document something. They got left down in radiology. The unit secretary is printing new labels. A student is doing research.
      But that patient’s arm is ALWAYS with them.
      Also, it is against the law (HIPAA) to leave the chart at the patient’s bedside. So, nobody can whine about a lack of privacy when it is the privacy that gets you into the same mess.
      When you are deathly allergic to penicillin, don’t you want EVERY measure taken to make sure you don’t accidentally get some? Hell, I’d have it on a tattoo on my forehead!

  31. mrgenius says:

    More Americans die in hospitals than anywhere else…stay away!

  32. picardia says:

    I don’t think this is a bigger risk to privacy than simply being in the hospital to start with — nurses and doctors can talk about your private business too loudly or while you’re in the hallway, your families can find out things you didn’t want them to know anyway, your chart is there for anybody to read, etc. And it seems like a very useful safeguard. As today’s penisectomy story made clear, you can’t be too careful.

  33. satoru says:

    I’m in the healthcare industry and it’s surprising that the Joint Commission is against this? They’re all about patient safety to the point that we have to implement retarded policies in order to satisfy this requirement. Now someone comes up with a decent idea and they decide to shut it down. Not surprising.

  34. baristabrawl says:

    What privacy? If you’re a fall risk, you’re not out of your hospital room. If you’re a DNR, chances are you’re circling the drain…you’re not out of your room. If you have allergies, it’s on your chart, or the medical staff is yelling that you have them, anyway. If you’re a no transfusions, it’s a religious thing and honestly, is there privacy protection for that? Honestly?

    Who cares, the average “other” patient is not looking at your writs for things and it’s not like they’re going to put an “HIV Risk” bracelet out there. If you’re following universal precautions then you’re protecting yourself against everyone, all the time. (Not that there’s really any protection, but you get what I’m saying.)

    Privacy, right.

  35. Applekid ┬──┬ ノ( ゜-゜ノ) says:

    Colored wristbands? Kids trading them? Is this a revamp of those oral-sex rainbow parties that Oprah made up?

  36. absentmindedjwc says:

    honestly, I dont mind the “privacy concern” if it means that they wont screw something up. I would be fine with a banner sized sign on the wall in neon green stating exactly what should not be done if it prevents mistakes.

    privacy concerns are starting to get ridiculous. Granted, some of them are warranted, but sometimes a little less privacy is what is required, I believe this to be one such example.

  37. fett387 says:

    Doesn’t the fact that a patient is located on the cardiology section of a hospital tell others about the same amount of info as a bracelet that says Allergy? It seem to me that it is very general information and not that big of a deal.

    • catastrophegirl chooses not to fly says:

      @fett387: but a patient isn’t always in the ‘appropriate’ wing. hospitals get more crowded every day. so once i was in for diabetic ketoacidosis but my room was in the neurology wing.
      i can’t think it’s uncommon either because several years ago i was in for dehydration and vomiting from being poisoned – and at age 21 they put me in the long term geriatric care wing because it was the only available bed.

  38. mackjaz says:

    I think the benefits outweigh the drawbacks for me.

  39. Khuluna says:

    Why not something like a Henna tattoo? I can see how on a child it might be rubbed off, but it would be a way to mark everyone clearly and untamperably. Maybe some other sort of temporary tattooing?

  40. Bog says:

    Privacy concerns or staying alive concern; what trumps which?

  41. ThinkerTDM says:

    These bracelets are an excellent idea. However, the frenzy over “privacy” has reached hysterical levels. Many people, especially those who actually work at medical offices, don’t understand HIPAA or confidentiality, and blindly go forward, asking everybody to wear paper bags over their heads to avoid “loss of confideniality”.
    True, the provider may be sued due to a lapes of confidentiality, but I can’t say it enough- HIPAA is very misunderstood and misused.

    • cadieg says:

      @ThinkerTDM: I AGREE. they scare us nurses into basically not talking about anything to anyone- but the scope of HIPAA is so much looser than that if you actually understand it. i wish they gave us realistic, down to earth classes on this stuff.

    • catastrophegirl chooses not to fly says:

      @ThinkerTDM: agree! a lot of health care professionals don’t understand HIPAA. i actually had a doctor’s assistant once tell me that i couldn’t get copies of my own medical records due to HIPAA. which is completely false. they can never refuse to give you your own records. they CAN charge you up to 50 cents a page for them but they have to hand them over if you are willing to pay.

      i suspect they were just suspicious that i was going to change offices. which i was, and did. sooooo many problems with that office that i feared for my life.

  42. GIZisGOD says:

    Shouldn’t DNR be in black? I mean I always picture Death in black…

  43. sam-i-am says:

    While I understand the privacy concerns – I would say I’m slightly more concerned about staying alive.

    Privacy can only go so far. I mean people are going to SEE you at the hospital and you can’t reasonably expect otherwise. I wouldn’t be very concerned if they also knew I had allergies.

  44. Grrrrrrr, now with two buns made of bacon. says:

    I say…spraypaint patients’ butt-cheeks…that way, it’s under the hospital gown.

    If it’s behind hospital walls, I’d trade some privacy for the staff being able to deduce important information about me at a glance.

    If there was a concern about something like HIV or drug addiction (or whatever), they could always use a colored band without anything printed on it..or use a special symbol or a number..or whatever…some kind of identification that isn’t readily known by the general public and that wouldn’t be readily identifiable by visitors (which would be my main concern).

  45. ShefaliCastor says:

    I think if you’re in the hospital and someone is reading what’s on your wristband, privacy is the least of your problems.

    • cadieg says:

      @ShefaliCastor: also: if you’re in the hospital and sharing a room with someone separated only by a curtain and hear everything the doctor/nurse/etc says to your roommate- wristbands are the LEAST of your concerns.

  46. mrsultana can't get a password to work says:

    Hey, I like the paper bag idea! When I’m having a patient transported through the hospital, they must wear a paper bag over their heads. It is a privacy violation, after all, for anyone to be able to see who you are and where you are going…

  47. jimmydeweasel says:

    Maybe we can make a bracelet that states “Homophobe” and give it to the moderator of this blog.

  48. Onouris says:

    Sorry reduce the number of deadly mistakes, but the cost is people know you have the shits?

    Downside here? No?

    No-one else gives a crap what the hell you have for christ sake. You wanna live don’t you?

  49. I’m allergic to codeine. When I had my son they put a bright red bracelet on me to notify everyone. When I complained of pain after the delivery they gave me a little cup with pills in them. Good thing I asked what they were. They were Tylenol with codeine. Any extra step to make sure mistakes aren’t being made is a good thing. If I hadn’t asked what I was taking I would have been in need of a DNR bracelet.

  50. North of 49 says:

    Those bands don’t work.

    Mrs. No49 was in the middle of birthing our first one with a red band with Pennicillin written on it in large letters when I turned to ask the nurse what she was hooking up to her iv.

    Mrs. No49 was seconds away from being killed by anaphalaxis all because a doctor didn’t read the chart, let alone the wristbands, or listen to either of us when when said she was allergic to it.

    Mrs. No49 has lost all trust in hospitals.

  51. baryl says:

    As someone who is (hopefully!) entering medical school next July, I can honestly say that I would love to have these colour-coded bracelets standardized. Doctors do try very hard to remember things like DNR orders or specific allergies, but they are human just like the rest of us. It really would make life so much easier on the doctor to see the patient’s red allergy bracelet or purple DNR bracelet if that patient is coding or unconscious or whatever the emergency situation may be.

    I hope that made sense; I’ve been up for quite a long time doing work on my thesis. Sleep is greatly needed.

  52. EdithPhorcys says:

    After watching my mother through two, three day stays where there were so many mistakes I felt I couldn’t leave. She had a restriction on one arm, no blood draws, no BP nada. Every morning I came in at 9, she had a f’ing bandaid over the spot they had taken blood. One morning a nurse semi bragged that she had removed an IV put in the wrong arm by the previous shift! Mom had a raging UTI, and was catheterized and had swallow problems, so needed fluids. I had to remind the DR that she should be getting IV fluids. Its shocking when you see error after error, each small but jeez, it’s my mom. Do you throw a fit? Stomp around? You have to leave them there eventually. Then no one is watching. The staff had posted large signs over her bed, with restrictions and no zombie CNA would read, let alone RNs. I witnessed a physical therapist give her a drink of water, where she was on a restricted diet texture, she coughed so she didn’t breathe it into her lungs. Food and drink particles in the lungs cause bacterial pneumonia, perfect on top of a stroke and seizures. I’d welcome the armbands if I thought they would work, but I doubt it. What is needed is personal advocates for each patient, impractical I know, but I can’t imagine what it would be like to be in the hospital awake and aware but unable to speak up for yourself.

  53. redkamel says:

    anyone who doesnt want these band hasn’t tried reading a chart. Its literally a bunch of forms, all different for a ton of different things, varying from hospital/clinic even its for the same thing, photocopied, and a written in doctor/nurse printing and cursive, with little proofreading or linearity. Some write pages about one behavorial event. Others get nonspecific, like “history of allergic reactions” It takes hours to read the charts, and most of it is not whatever YOU need. Oh yeah, and sometimes its not where its supposed to be. EMR is the way to go, someone just needs to make a really good standard interface and forms. I swear the only positive thing I look forward to if they nationalize the healthcare system is a standard EMR.

    Plus its hard to keep things like allergies and meds straights when patients are constantly changing and you get the same things in different combos…the details of pts DO start to blur after a while. Thats why docs have sign outs in the hospital…its essentially the cliffs notes version of your chart.

  54. redkamel says:

    also, the privacy stuff is ridiculous. You are in hospital. It is full of sick people. No one cares that you are sick too. You will never see these people again. Half the stuff people are sensitive about doesn;t even really matter to other people, or is considered remembering/gossipable…your allergies? fall risk? no blood transfusion? blood precautions? DNR (if people even know what that means, or care about your choice)? Its not like they advertise personal things like your social life/sex orientation/fam hx/STDs…

  55. redkamel says:

    by “no one cares” I mean it is “not a big surprise to other people”. I do care that you are sick.

  56. mrearly2 says:

    I wouldn’t worry about privacy. Between the doctors, hospital staff and prescription drugs, you’ll be fortunate to make out alive (or functional), anway.

  57. Elderbear says:

    Colored wristbands are an ergonomic and safety feature. They give important information for providers at a glance (when a patient has pulled out their breathing tube and IVs and is running naked down the hall, one doesn’t have a chance to consult their chart).

    Bar codes (or RFID or [special technology here]) allow some good error checking to be done. For example, scanning a bar code on medication and then on the patient’s wrist allows checking to see if that medication applies to any of the patient’s conditions. If not, chances are an error has been made (remember, about 100,000 people die in the USA due to hospital/medical errors) or an “off label” order has been given. In the later case, allowing an override by MD or charge nurse should be OK.

    There is a place for both lo-tech (color) and hi-tech (bar code, RFID, etc).