Process evaluation of the implementation of colour-coded wristbands for signalling special patient status on a neurology ward
Rationale, aims and objectives: Colour-coded wristbands (CCWs) are widely used to signal special patient status to health care professionals. However, little is known about the feasibility of CCWs. The current study describes a process evaluation of an intervention in which CCWs were used to signal special patient status to health care professionals on the neurology Ward of a university hospital in the Netherlands. In this intervention, CCWs were issued to patients with an increased risk of falling and patients with dysphagia.
Methods: Quantitative and qualitative methods were used to evaluate the reach of the intervention, performance according to protocol, compliance to the intervention, staff’s opinion on the intervention, and contextual factors that may have affected the implementation of the intervention. Data were gathered by means a self-administered questionnaire among the care professionals on the neurology ward and by means of a semi-structured interview among a subgroup of care professionals who guided the implementation process on the ward.
Results: Five care professionals were interviewed and 23 care professionals (57.5%) responded to the questionnaire. Most professionals indicated they had received information about the CCWs and their role in conducting the intervention. The intervention was largely performed according to protocol, however some deviations from protocol were reported with respect to how family members were informed of the intervention, how the CCWs were issued, and how often patients were inspected for having the appropriate CCWs. Overall, staff members evaluated the intervention positively and perceived patients to be content with the CCWs.
Conclusion: We conclude that the CCWs were largely implemented according to protocol. Our findings highlight some challenges that can arise when implementing CCWs. Recommendations are made to optimize the feasibility of the intervention.