| Description |
Background: Code blues are one of the most intense, stressful, and mistaken prone situations in all of healthcare (Hatley, Jordan, Powers, & Morton, 2019). In the long term acute care hospital (LTAC) setting, very sick patients are cared for, but not many code blue emergencies occur. Therefore, clinical staffs' code blue skills perish quickly. The objective of this project was to improve code blue times as well as staff comfort and knowledge levels regarding code blues in an LTAC hospital setting through mock code simulations.Methods: Before the implementation of the mock code simulation program, a retroactive chart review was performed to determine a baseline of team effectiveness in code blue emergencies, and pre-mock code surveys were completed by simulation participants. Pre-mock code surveys collected data on staff comfort levels regarding code blue emergencies using a sliding scale of 1-Not comfortable at all, to 5-Very Comfortable. The survey also tested ACLS certified staff on cardiac rhythm recognition and ACLS algorithm knowledge. A mock code simulation training was created and implemented, and attendance was made mandatory for all staff members that were BLS or ACLS trained. The simulations were designed to be sociable, with one team performing a scenario, and the other team observing. After each simulation, teams would reverse roles, and then a debriefing was held. The simulations were based upon code blue emergencies that had occurred in the hospital, focusing on rhythm recognition and ACLS protocols. Following the mock code simulations, the staff completed a post-mock code survey. The post mock code survey was identical to the pre-mock code survey, so the data produced would be directly comparable pre-to-post mock code simulation. Another chart review was performed to determine if code blue team efficacy had improved in reality post mock code simulation training Results: There were 80 participants. Of those 80, four were providers, 40 were Registered Nurses, 30 were Patient Care Technicians, and six were Respiratory Therapists. All of the participants were BLS certified, and 23 were ACLS certified. BLS staff reported changed comfort levels involving BLS algorithms, with 37% reporting they were not comfortable at all pre-mock code simulation to 0% reporting they were not comfortable at all post-mock code simulation (p=.001). ACLS staff reported changed comfort levels regarding ACLS algorithms, with 23% reporting being not comfortable at all pre-mock code to 0% reporting they were not comfortable at all post mock code simulation training (p=.002). Code blue emergency team efficiency did improve, though not to a statistically significant degree. Conclusions: The objective of improving staff comfort and knowledge levels surrounding code blue emergencies was achieved. The objective of improving code blue team efficiency was not reached to a statistically significant degree. Observed and anecdotal evidence indicates that staff are much more prepared to care for patients experiencing a code blue emergency. |
