Improving Code Blue Response Through the Use of Simulation

Abstract

In this research project, the response times to chest compressions, first defibrillation, and first dose of epinephrine in cardiac arrest were measured over a 3-month period through retrospective chart reviews. All nursing staff then participated in random, unannounced mock code blue drills using a high-fidelity patient simulator. After 3 months of code blue drills, the variables were again measured in patient code blue situations and compared with the response times before training. At the conclusion of this study, the response times for start of chest compressions and epinephrine administration improved significantly; the response time to defibrillation did not improve significantly. The response times were measured for an additional 3-month period to assess if the improvement was sustained.

Development of Crisis Resource Management Skills: A Literature Review

“…Out of the thirteen studies, three commented that learning was not retained over time (Gilfoyle at al., 2007;Huseman, 2012;Liaw at al., 2010). This suggests that with CRM skills in a high-fidelity learning environment improved at least in the period following the education initiative.…”

“…Two studies used chart reviews to assess problem-solving. Huseman (2012) looked at response times during codes, while Wolf (2008) looked at rates of under-triage in an emergency department.…”

“…As noted above, all of the studies reviewed included simulation-based learning using a high-fidelity simulator. Thirteen studies compared pre-test and post-test results following an HFS learning program (Buckley & Gordon, 2011;Dadiz et al, 2013;DeVita et al, 2005;Gilfoyle et al, 2007;Huseman, 2012;Jankouskas et al, 2007;Liaw et al, 2011;Przybyl et al, 2015;Schubert, 2012;Shinnick & Woo, 2013;Sittner et al, 2009;Straka et al, 2012;Wolf, 2008). Standard education was compared to standard education plus HFS learning in four studies (Hall, 2015;Jankouskas et al, 2011;Maneval et al, 2012;Singer et al, 2013).…”

Workers' Clinical Skills at Out-of-Hospital Emergency Care

“…Patient simulators can also be useful in practising airway maintenance. Simulation learning has been found useful for example in helping learners recognize the need for resuscitation and start chest compressions faster [33,34]. Part of the respondents was insecure about their pharmacological skills.…”

Implementing an in Situ Mock Code Quality Improvement Program

“…7,8 Nurses experience high levels of anxiety and have difficulty recalling the knowledge and demonstrating the skills required during medical emergencies. 9,10 However, the use of mock code simulation can improve nurses' confidence and performance. 6,9,11 The high risk and low volume of medical emergencies, combined with the annual competency sessions and biannual recertification training, on 2 progressive care units at Mayo Clinic Hospital-Rochester, St Mary's Campus, established the importance of transforming how nurses are trained to respond to medical emergencies.…”