Joint Commission Recommendations on Tubing Misconnections Product Literature
Don’t Confuse the Connection!!
1Never use a standard luer syringe for oral medications or enteric feedings. In addition, the Joint Commission urges product manufacturers to implement “designed incompatibility,” as appropriate, to prevent dangerous misconnections of tubes and catheters.
In regard to Color Coding ECRI Institute offers the following guidance:
2Color-coding tubes and catheters— This can lead users to rely on the color coding rather than assuring a clear understanding of which tubes and catheters are connected correctly to which body inlets. In addition, the training and educating of all staff (including temporary agency and travel staff) about the institution’s color-coding system requires continuing attention. Finally, color-coding schemes often vary across institutions in the same community, creating increased risk when agency and travel staff are used.
In other words, be it orange OR purple… the key is implementing “designed incompatibility,” to prevent dangerous misconnections of tubes and catheters.
There are no established color standards by safety or regulatory agencies in the US. Orange is the most recognized and trusted color in Enteral devices.
1 JCAHO Sentinel Event Alert, Tubing misconnections—a persistent and potentially deadly occurrence, Issue 36 - April 3, 2006
2 “Preventing Misconnections of Lines and Cables,” ECRI, Health Devices, March 2006; 35(3):81-95