Unit-based mock Code Blues keep patients in-the-pink
Responding to a Code Blue on a hospital inpatient unit is, undoubtedly, one of the most stressful events a ward nurse will ever experience.
Unlike their colleagues in the ED or ICU, ward nurses do not regularly deal in life-and-death scenarios, as patients arrive onto an acute-care ward, stabilized to the point where sudden death is typically thought to be unlikely. But Code Blues do happen and, when they do, it’s important that every health care professional is well-versed in how to respond to these emergencies to ensure better outcomes for all patients.
“We run classroom-based mock code scenarios about once a year,” said Norm Greenway, Clinical Nurse Educator, 3 Medicine Acute, “but staff told us that they would like more opportunities to practice. So rather than continue the classroom sessions, we felt the best learnings would come from doing unit-based training, using real environments, equipment and processes.”
Putting it into practice
The first unit-based mock Code Blue ran on 3 South in early November. ED Clinical Educators Fiona Francis and Catherine Marshall, and Dr. Kate Hudson offered-up the session, and staff gladly accepted. Although ED staff had run a few mock codes in the ED, one had never before been held on an in-patient unit.
This is how it rolled out:
“The plan was to set up a 3 South patient room with an advanced function Resusci-Anne, then have one of our staff ‘find’ Anne in arrest, and begin the Code Blue process. At the last minute, we could not find an appropriate patient room, so we had Anne arrest in the 3 South rehab gym. We had given the rehab therapists, nurses and unit clerks a heads up regarding our plans so, at 1400, we had them find Anne, and begin the mock Code Blue.
MaryAnne (PT) began CPR and the rehab assistant called out for help. Debbie, the NUC, called the switchboard and announced ‘mock Code Blue on 3 South.’ Within moments, the page went out overhead. Just like in a real Code Blue, within minutes the rehab gym was full of people! All of the usual code team responded, exactly like in a real code.
Nurses from 3 South rushed in to assist, as did nurses and RTs from ICU. One of the ED physicians responded, as did lab staff, ECG technicians and the porter. This quickly became just like a real Code Blue, with lots of activity and noise, with stress levels climbing close to the real thing. People took this practice very seriously, and acted like this was a real patient, and we were giving her our all!
After working on our patient for 20 minutes, we successfully resuscitated Anne.”
The learnings take-away
An inclusive, informative debrief followed the November 3 exercise, and provided both ward and critical care staff the opportunity to discuss how things went as well as to gain a better understanding about each other’s experiences with Code Blue response.
All of the 3 South staff voiced how real and stressful this exercise felt, and that mock codes were a great way of ensuring that staff are able to provide high levels of care regardless of how and where they present across Richmond Hospital.
Coming to a ward near you!
Are you interested in having a mock Code Blue on your ward? If so, please connect with Fiona Francis, Fiona.francis@vch.ca. The goal is to run one unit-based mock Code Blue every month at Richmond Hospital.