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Poster presentation
Session H presented Tuesday, October 1, 2:30-3:30 pm
Purpose: This project was completed to demonstrate that mock code blues and rapid responses improve nurse’s confidence and competence in actual emergent events. Quick response times and confidence in appropriate actions taken by nursing staff are vital to patient outcomes during rapid responses and code blues. It was discovered that new and seasoned nurses alike do not feel confident in running or being part of rapid responses and code blues.
Design: This quality and safety project initially was my new graduate nurse residency project when I started at Duke Raleigh Hospital. After many conversations, it was decided to expand and implement this as an evidence-based practice project with hopes of eventually expanding it across the health system.
Setting: This program has so far been implemented on multiple units at Duke Raleigh, a smaller community campus of Duke University Health System. There is hope to eventually expand this program across the other Duke facilities.
Participants/Subjects: All staff from hospital units were encouraged to participate. There was a variety of staff including nursing assistants, nurses, management and advanced practice providers who took part in scenarios.
Methods: An unplanned code simulation was done initially to assess the most needed learning points. As a group, we have since been conducting planned scenarios beginning with a run through of code cart items and defibrillator functions. The group then completes a scenario (similar to an ACLS megacode) followed by a debrief to discuss what went well, areas of improvement, ask questions and provide extra time with the equipment. Pre and post simulation surveys were completed to evaluate program effectiveness and assess confidence in the following categories: recognizing/calling a code, locating code cart items, opening/giving boxed drugs, performing cardiopulmonary resuscitation, using a bag-valve-mask, recognizing rhythms, roles, and communication. The Likert-like survey items were rated using 1=not comfortable at all, 3=neutral, 5= Very comfortable. Scenarios were conducted on all shifts and at a variety of times.
Results/Outcomes: Pre-intervention results were: 1-14.81% 2-22.96% 3-22.96% 4-26.67% 5-12.59%. Post-intervention results showed a trend towards increased comfort: 1-3.70% 2-7.41% 3-28.15% 4-28.89% 5-31.85%. These improvements in staff confidence and comfort promote quality patient care and safety during emergent events. This intervention has been successfully implemented with positive results. The staff has expressed how these scenarios have eased fears and anxiety related to emergent situations. The staff has also informed us that they feel the completion of these scenarios have improved confidence in recognizing, emergency situations and also being apart of rapid responses and code blue events. We plan to continue the simulations with staff throughout the hospital and into the emergency department.
Implications: With new and seasoned staff alike there is always room for education and learning. Mock scenarios can be beneficial for these types of situations where there is not a great deal of time to stop and think. Nurses, especially in the emergency department, are quick thinkers on their feet and it is important for them to feel confident in their decisions and skills. A program like this is helpful to do that and help improve patient outcomes.
Type | Poster |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | N/A |
Keywords | Mock; Code; Emergent |
Name | Emergency Nursing 2019 |
Host | Emergency Nurses Association |
Location | Austin, Texas, USA |
Date | 2019 |
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