A Descriptive Study of Chaplains’ Code Blue Responses

Abstract

Background Family presence during resuscitation is the compassionate practice of allowing a patient’s family to witness treatment for cardiac or respiratory arrest (code blue event) when appropriate. Offering family presence during resuscitation as an interprofessional practice is consistent with patient- and family-centered care. In many institutions, the role of family facilitator is not formalized and may be performed by various staff members. At the large academic institution of this study, the family facilitator is a member of the chaplain staff. Objectives To examine the frequency of family presence during code blue events and describe the role of chaplains as family facilitators. Methods Chaplain staff documented information about their code responses daily from January 2012 through April 2020. They documented their response time, occurrence of patient death, presence of family at the event, and services they provided. A retrospective data review was performed. Results Chaplains responded to 1971 code blue pages during this time frame. Family members were present at 53% of code blue events. Chaplains provided multiple services, including crisis support, compassionate presence, spiritual care, bereavement support, staff debriefing, and prayer with and for patients, families, and staff. Conclusions Family members are frequently present during code blue events. Chaplains are available to respond to all such events and provide a variety of immediate and longitudinal services to patients, families, and members of the health care team. Their experience in crisis management, spiritual care, and bereavement support makes them ideally suited to serve as family facilitators during resuscitation events.

Developing a Decision Pathway for Family Presence During Resuscitation

“…Our team reviewed the baseline prevalence and management of FPDR within the institution. In our review of chaplain code blue documentation from the years 2012 to 2019, we found that family were present at just over 50% of inpatient code blue events documented by chaplains, 29 which confirmed the incidence of FPDR and emphasized the broad scope of the chaplain during resuscitation events. These data were shared throughout the institution and supported the relevance of the pathway development.…”

“…Chaplains documented family presence in 39% of code blue events from May 2021 to May 2022 compared with an average frequency of 53% in the 9 years before that. 29 Visitor restrictions related to Coronavirus may have influenced this frequency. This finding suggests that the pathway did not increase the occurrence of FPDR at this institution.…”

“…During the year after implementation, the frequency of FPDR was slightly less. Chaplains documented family presence in 39% of code blue events from May 2021 to May 2022 compared with an average frequency of 53% in the 9 years before that 29 . Visitor restrictions related to Coronavirus may have influenced this frequency.…”

“…Health care chaplains are often employed in health care institutions and care for families as they witness resuscitation and make end-of-life decisions. Chaplains have an emerging role in health care ethics, 26,28 but their role as FFs has only begun to be studied and described in detail 26,29 …”

“…Chaplains have an emerging role in health care ethics, 26,28 but their role as FFs has only begun to be studied and described in detail. 26,29…”