Staying Alive: Code Prevention With Early Intervention

Leonard J. Chabert Medical Center (Houma, Louisiana)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic

Preventing code blues on med-surg units

Hospital Units

Medical Surgical Telemetry – 4 West
Post-Op Medical Surgical/Pediatric – 5 East

CSI Participants

Megan Fondren, BSN, RN, CCRN
Kelseylynn Leabo, BSN, RN
Jeanie Songe, BSN, RN, CCRN-K

Project Goals/Objectives

  1. To increase rapid responses calls 15%
  2. To educate 90% of staff on clinical signs of early deterioration
  3. To decrease the number of code blue calls 15%
  4. To decrease the number of transfers to the intensive care unit following a rapid response call

Project Outcomes

  1. Increased rapid response calls 23%
  2. Decreased code blue calls 75%
  3. Increased patients remaining on the unit after rapid response call 10%
  4. These outcomes resulted in an estimated annual fiscal impact of $37,863.

Project Overview

Nurses working on 4 West and 5 East were not recognizing the clinical signs of patients’ deterioration. This resulted in the nurses calling a code blue, which may have been avoided with early recognition of a patient’s deterioration and calling a rapid response.

Our CSI team provided an education forum at our departments’ monthly staff meetings. The forum consisted of four stations:

  1. Review of what a rapid response is and our facility’s rapid response policy
  2. A hands-on demonstration of charting a rapid response in the electronic health record
  3. Respiratory
  4. Mock code

In addition, meaningful rounding was implemented by the administrative coordinators.

After eight months, we were excited because we had exceeded our goals. We also noted that the nursing staff felt open to discussing their patients with the administrative coordinators and charge nurses, resulting in improved communication. In addition, ACLS (advanced cardiovascular life support) certification is now a requirement for the nurses on both units.

Our sustainability plan is to include rapid response as a discussion topic during the huddles of both units. In addition, the administrative coordinators will continue meaningful rounding. The goal of our CSI team is to spread the education processes to our neighboring facilities in the Bayou Region.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.