Yellow-sashed nurses

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• Byron Y. Newman, O.D.

If it catches on, the next time you or an acquaintance is in the hospital, don't be surprised if the nurse dispensing the medication is wearing a bright yellow sash like a scout showing off merit badges.

This yellow sash is part of MedRite, started at Kaiser's Sidney R. Garfield Health Care Innovation Center as a warning to others not to distract that nurse as she (or he) is in the process of dispensing medications.

According to an article by Anne Federwisch in NurseWeek Magazine (http://news.nurse.com/apps/pbcs.dll/article?AID=/20080714/CA01/107140073), the idea to have staff wear bright sashes or vests while dispensing medication is to prevent distraction by others. This addition to nursing attire was promoted by adult clinical director Becky Richards, R.N., who encouraged this after reading the work of Tess Pape, R.N., Ph.D., who pioneered the idea.

The effect has been impressive. Nurses wear brightly colored garments with the wording “Caution: Medication Administration in Progress” that alerts anyone around them or the patient that they are dispensing medication and should not be sidetracked. Interestingly, initially the staff wore orange construction vests but rather than being left alone, both staff and patients asked why they were wearing the very colorful garb. Yet, even though the nurses were not thrilled about wearing orange construction vests, they found at the end of this 6-month pilot program that they had a 47% decrease in medication errors. In response to the positive outcomes, Kaiser modified the attire and educated everyone not to interrupt nurses wearing the yellow sash. So the process now is as follows: the nurses “don the sash, check the medication administration record using the five ‘rights’ (the right medication at the right time for the right patient at the right dose by the right route), wash their hands, get the proper medication, turn down the TV or radio in the patient's room, turn up the lights, double-check the patient's identity, discuss the medications with the patient, administer the medication, document the delivery, and wash their hands again before removing the sash.”

“In the past, nurses were routinely interrupted while passing medications,” reports the article, and thus with this great improvement, the MedRite procedure has been implemented in many Kaiser hospitals and has even spread to other hospitals because of Kaiser's success. Some hospitals call the procedure “MedSafe.”