Abstract 355: Using Low-Fidelity Simulation with Hospital Specific Equipment to Improve Front Line Nursing Staff Knowledge, Skill, and Confidence in a Code Blue

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Shauna R McCullough-Leewright
Keyword(s):  
Nursing Staff ◽  
Life Support ◽  
Advanced Life Support ◽  
Rapid Response Team ◽  
Front Line ◽  
Improve Performance ◽  
Document Code ◽  
Code Blue ◽  
Response Team ◽  
Facility Staff

Introduction: At this facility, staff response to unresponsive victims prior to arrival of Rapid Response Team is unreliable. The gaps in care reported by debrief forms include unable to find and use equipment on the crash cart, unable to appropriately document Code Blue in EHR, and not performing adequate CPR. Currently, the nursing staff is required to maintain Basic Life Support (BLS) and Advanced Life Support (ALS) (per their job description) via the Resuscitation Quality Improvement (RQI) program. RQI delivers quarterly training via computer scenarios and mannequin simulations. There is no consideration in RQI for hospital specific equipment or processes. The recommendation for improving staff response to code situations is to incorporate an annual Mock Code Event for all nursing staff to improve performance during code situations, in addition to RQI quarterly activities. Hypothesis: Participating in an instructor led Mock Code Event annually to review hospital specific equipment and processes, along with the quarterly RQI simulations, will improve staff response to code blue situations. Methods: The Mock Code Event included stations to review items in crash cart, use of defibrillator, documenting in EHR, and review of BLS. After completing the stations, the staff participated in a low-fidelity code blue simulation with a debrief. At end of activity, participants voluntarily completed a survey regarding Mock Code Event. Results: The participants scored 6 items on a Likert scale (from 1 disagree to 5 agree). 457 RNs and PCTs attended Mock Code Events in 2019. 189 completed survey after event. Conclusion: The survey findings demonstrate the Mock Code Event was an effective method to improve knowledge, skill, and confidence of front-line staff during Code Blue situations. The survey findings support that the educational techniques used were helpful and easy to understand.

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

scholarly journals Governance of Rapid Response Teams in Australia and New Zealand

2018 ◽  
Vol 46 (3) ◽  
pp. 304-309 ◽  
Author(s):  
S. S. Sethi ◽  
R. Chalwin
Keyword(s):  
New Zealand ◽  
Life Support ◽  
Advanced Life Support ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Public Hospitals ◽  
National Standard ◽  
Local Network ◽  
Public And Private ◽  
Benchmark Assessment

Rapid response systems (RRS) in hospitals in Australia and New Zealand (ANZ) have been present for more than 20 years but governance of the efferent limb—the rapid response team (RRT)—has not been previously reported in detail. The objectives of this study were to describe current governance arrangements for RRTs within ANZ and contrast those against expected implementation, using the Australian Commission for Safety and Quality in Health Care National Standard 9 (S9) as a benchmark. Assessment focused on S9 subclauses 9.1.1 (governance and oversight), 9.1.2 (RRT implementation), 9.2.3 (data collection and dissemination), 9.2.4 (quality improvement), 9.5.2 (call reviews), 9.6.1 and 9.6.2 (basic and advanced life support [ALS] skill set). We identified public and private hospitals across ANZ from government-maintained registers. Those reasonably expected to have an RRT were contacted and invited to participate. Responses were obtained via an online anonymised questionnaire. Three hundred and forty-two hospitals were contacted, of whom 284 (83.0%) responded. Two hundred and thirty-two hospitals submitted data, and the other 52 declined to participate or did not have an RRT. In hospitals with an intensive care unit (ICU), intensivist attendance at RRT calls occurred less often outside office hours (odds ratio, OR, 0.49, 95% confidence interval, CI, 0.32 to 0.75]). Where intensivists were not on the RRT, consultation with them about calls also occurred less often outside office hours (OR 0.39, 95% CI 0.22 to 0.66). Consultation with patients’ admitting specialists occurred more often during office hours versus out of hours RRT calls and in private versus public hospitals. The presence of ICU staff on the RRT decreased the likelihood of admitting specialists being consulted about RRT calls (OR 0.66, 95% CI 0.47 to 0.93). Most hospitals maintained databases of RRT calls and regularly audited RRT activity (92% and 90% respectively). However, most (63.7%) did not make that information available beyond their hospital or local network. We concluded that the majority of hospitals in the ANZ region had governance mechanisms for their RRT. However, there was a notable lack of consistency, especially around specialist involvement and audit processes. Although some findings from this study are reassuring, there is still potential for improvement. Further development of guidelines and the establishment of a regional RRS database may assist with achieving this.

scholarly journals Effect of a Rapid Response Team on Patient Outcomes in a Community-Based Teaching Hospital

2014 ◽  
Vol 6 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Ankur Segon ◽  
Shahryar Ahmad ◽  
Yogita Segon ◽  
Vivek Kumar ◽  
Harvey Friedman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Inpatient Mortality ◽  
Rapid Response Teams ◽  
Community Based ◽  
Code Blue ◽  
Response Team

Abstract Background Rapid response teams have been adopted across hospitals to reduce the rate of inpatient cardiopulmonary arrest. Yet, data are not uniform on their effectiveness across university and community settings. Objective The objective of our study was to determine the impact of rapid response teams on patient outcomes in a community teaching hospital with 24/7 resident coverage. Methods Our retrospective chart review of preintervention-postintervention data included all patients admitted between January 2004 and April 2006. Rapid response teams were initiated in March 2005. The outcomes of interest were inpatient mortality, unexpected transfer to the intensive care unit, code blue (cardiac or pulmonary arrest) per 1000 discharges, and length of stay in the intensive care unit. Results Rapid response teams were activated 213 times during the intervention period. There was no statistically significant difference in inpatient mortality (3.13% preintervention versus 2.91% postintervention), code blue calls (3.09 versus 2.89 per 1000 discharges), or unexpected transfers of patients to the intensive care unit (15.8% versus 15.5%). Conclusions The implementation of a rapid response team did not appear to affect overall mortality and code blue calls in a community-based hospital with 24/7 resident coverage.

scholarly journals House Staff Perceptions of How Handoff Quality Influences Code Blue and Rapid Response Team Events

2014 ◽  
Vol 30 (3) ◽  
pp. 292-293
Author(s):  
Deana Miller ◽  
Aaron Mitchell ◽  
Rebecca Sadun ◽  
Judy Milne ◽  
Joel Boggan
Keyword(s):  
Rapid Response Team ◽  
Rapid Response ◽  
House Staff ◽  
Staff Perceptions ◽  
Code Blue ◽  
Response Team

Exploring Differences in Rapid Response Team (RRT) and Code Blue Occurrence Rates Within the Context of Nurse–Patient Linguistic Compatibility

2011 ◽  
Vol 9 (4) ◽  
pp. 194-198
Author(s):  
Rachel M. Failano ◽  
Jeffrey M. Adams ◽  
Irene Ramirez Neumeister ◽  
Chia-Chuan Chang
Keyword(s):  
Rapid Response Team ◽  
Rapid Response ◽  
Code Blue ◽  
Response Team

Mise en place et organisation d’une équipe médicale mobile de réponse précoce aux urgences intra-hospitalières (Rapid Response Team)

2020 ◽  
Author(s):  
Boris Jung ◽  
Gerald Chanques ◽  
Samir Jaber ◽  
Kada Klouche
Keyword(s):  
Rapid Response Team ◽  
Rapid Response ◽  
Prise En Charge ◽  
Response Team

La mise en place d’une Rapid Response Team a pour objectif la mise en place d’une structure de réponse hospitalièrepour la prise en charge des urgences vitales et surtout une réponse précoce à la dégradation clinique des patientshospitalisés avant que l’urgence vitale ne survienne. Nous discutons dans ce manuscrit le rationnel et le niveau depreuve motivant la mise en place d’une Rapid Response Team ainsi que les freins qui doivent être surmontés pour lesuccès de cette mise en place.

Sign in / Sign up

Export Citation Format

Share Document