I recently worked with a facility that used red allergy bands they had

sharpie markered with each patient’s allergies. They get kudos for patient

safety, but it was definitely not the most efficient practice.

I could just see the staff going through each chart, writing the list of

allergies on each band, and placing it on the chart to later place on the

patient for surgery.

The process offered an opportunity to consider patient identification in


We all know to use two identifiers to check to make sure we have the

right patient. However, is the person who places the identification band

on the patient requesting that the patient verify the information is correct

prior to placement? It is much easier and safer to correct before placing

the band on the patient.

Are staff are remembering to look at the identification band and having the

patient state the information? We all know how agreeable patients can be

after a little Versed. Check out the process in your facility. The result of

the observation can provide a nice quality study to boot.

Where do you look to verify allergies? Since allergies need to be part

of the pre-operative assessment, it is a good idea to have one common

space in the medical record that everyone references to verify allergies.

Paper records often allow for several locations where allergies are

documented, and updates may get missed.

In case you were wondering, the facility that was using the sharpie the

red band method has updated their process to use color coded bands with

patient identification stickers. Those without allergies get white bands,

and those with get red bands. Everyone gets asked about allergies, but

the red band provides an alert.

They also use a yellow band on extremities that cannot be used (ie:

mastectomy, shunt), so that there is a clear indication not to use the

limb for interventions. I loved this idea. The process adds to the

patient’s safety and clearly identifies the issue if missed in hand-off


Take a quick second look at your policy, make sure it matches your

process by doing an observation, and document the task as a quality study

to report to your board. You’ll either have confidence that everyone is

doing a great job, or you may shore up your processes. You may even

retire a sharpie or two.