2.50
Hdl Handle:
http://hdl.handle.net/10755/162554
Type:
Presentation
Title:
Crash Course: Resuscitating the Code Blue Process
Abstract:
Crash Course: Resuscitating the Code Blue Process
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Winokur, Elizabeth, RN, MSN, CEN
P.I. Institution Name:St. Joseph Hospital
Title:Clinical Educator, Emergency Services
Contact Address:1100 W. Stewart Drive, Orange, CA, 92863, USA
Contact Telephone:714-771-8250
[Annual Conference] Clinical Topic: Resuscitation is a complex process that requires optimal performance from all team members. At our institution, resuscitation documentation serves several critical functions: physician order sheet, progress notes, medication record, and nursing notes. A fall 2007 review of resuscitation records demonstrated significant deficits with documentation; 70% of all records lacked sufficient data to determine whether ACLS protocols were followed. Evaluation of reviewable records demonstrated several with deviation from ACLS protocol. In an attempt to address these issues, members of the Code Blue Committee developed Crash Course.

Implementation: Crash Course was designed for RN members of the Code Blue Team. The roles of code nurse are assigned to critical care and ED RNs; because the role rotates among staff, all RNs from these areas require training. In order to address the above identified issues four objectives were developed: (1) to improve resuscitation documentation, (2) to review current ACLS protocols, (3) to review the new biphasic defibrillator, and (4) to provide RN staff the tools to respond to MD orders that deviate from ACLS protocol. Simulated code blues, an example of experiential learning, were used as the primary teaching methodology. During the 2-hour class session, RNs receive a brief introduction to code blue documentation including expectations and frequently encountered issues. Nurses then participate in several mock codes. In each scenario four to five RNs assume code team roles while all other class members record code events. Coaching is provided as necessary to ensure that ACLS protocol is followed during the simulation. Instructors role-play family members and physicians at the code, students are presented with common, problematic situations that must be successfully managed. After each code the instructors review the code records for accuracy and debrief the class.

Outcomes: Approximately 200 RNs (greater than 90% of RNs in ED and Critical Care) attended Crash Course during 2008. A review of code blue documentation in December demonstrated that documentation was sufficient to review 100% of resuscitation records. The majority of common documentation errors were eliminated. Deviations from ACLS protocol were also reduced. Crash Course was designed as a one-time class to update the RNs; however, based on staff comments and research supporting loss of ACLS knowledge over time, the course has been made mandatory for all code team RNs on a biannual basis- in the year opposite ACLS recertification.

Recommendations: Resuscitation is a low volume, high risk activity. Optimal performance is essential. Significant improvements have been made in documentation and resuscitation behaviors in our facility as a result of Crash Course, a simulated active learning strategy. This course requires few material resources and is easily transferrable to other institutions. Finally, although deviations from ACLS protocol have been reduced and team dynamics have been improved, additional interventions targeted at physicians have been planned.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCrash Course: Resuscitating the Code Blue Processen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162554-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Crash Course: Resuscitating the Code Blue Process</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Winokur, Elizabeth, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Joseph Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Educator, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1100 W. Stewart Drive, Orange, CA, 92863, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">714-771-8250</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">beth.winokur@stjoe.org</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Resuscitation is a complex process that requires optimal performance from all team members. At our institution, resuscitation documentation serves several critical functions: physician order sheet, progress notes, medication record, and nursing notes. A fall 2007 review of resuscitation records demonstrated significant deficits with documentation; 70% of all records lacked sufficient data to determine whether ACLS protocols were followed. Evaluation of reviewable records demonstrated several with deviation from ACLS protocol. In an attempt to address these issues, members of the Code Blue Committee developed Crash Course.<br/><br/>Implementation: Crash Course was designed for RN members of the Code Blue Team. The roles of code nurse are assigned to critical care and ED RNs; because the role rotates among staff, all RNs from these areas require training. In order to address the above identified issues four objectives were developed: (1) to improve resuscitation documentation, (2) to review current ACLS protocols, (3) to review the new biphasic defibrillator, and (4) to provide RN staff the tools to respond to MD orders that deviate from ACLS protocol. Simulated code blues, an example of experiential learning, were used as the primary teaching methodology. During the 2-hour class session, RNs receive a brief introduction to code blue documentation including expectations and frequently encountered issues. Nurses then participate in several mock codes. In each scenario four to five RNs assume code team roles while all other class members record code events. Coaching is provided as necessary to ensure that ACLS protocol is followed during the simulation. Instructors role-play family members and physicians at the code, students are presented with common, problematic situations that must be successfully managed. After each code the instructors review the code records for accuracy and debrief the class. <br/><br/>Outcomes: Approximately 200 RNs (greater than 90% of RNs in ED and Critical Care) attended Crash Course during 2008. A review of code blue documentation in December demonstrated that documentation was sufficient to review 100% of resuscitation records. The majority of common documentation errors were eliminated. Deviations from ACLS protocol were also reduced. Crash Course was designed as a one-time class to update the RNs; however, based on staff comments and research supporting loss of ACLS knowledge over time, the course has been made mandatory for all code team RNs on a biannual basis- in the year opposite ACLS recertification. <br/><br/>Recommendations: Resuscitation is a low volume, high risk activity. Optimal performance is essential. Significant improvements have been made in documentation and resuscitation behaviors in our facility as a result of Crash Course, a simulated active learning strategy. This course requires few material resources and is easily transferrable to other institutions. Finally, although deviations from ACLS protocol have been reduced and team dynamics have been improved, additional interventions targeted at physicians have been planned.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:09Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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