10484
Implementing a Code Blue Response Team in a Free Standing Ambulatory Setting
The Pediatric Care Clinic provides 46K visits annually in primary care in an academic setting. In 2011 the clinic relocated from a hospital-based location, with a formal code blue team, to a free standing facility with no such support. Staff was uncomfortable in becoming their own "Code Blue Team".
Significance:
Patient safety could only be met by increasing the staff competency and comfort level in responding to patient emergency situations. The staff team consists of members who primarily have no critical care experience.
Strategy and Implementation:
In December 2010 we began to plan for the move scheduled for the Winter/Spring of 2011. We began talks with the clinic's leadership and the hospital's resuscitation team leadership. We discussed the following: the location and hours of the new clinic, the need for staff education, previous emergency events in our clinic, Code Blue team composition, crash cart contents, and necessary revisions to the hospital's policy and procedure. Over the next 4 months we continued to meet regularly. Dates for training were set for April 2011, 2-3 weeks before the clinic relocation. Code Blue training was provided to 109 clinic staff including: RN's, LPN's, APRN's, RT's, care assistants, social workers and physicians. This training included the use of simulation technology, which provided staff a safe place to practice their new skills. The training was facilitated by experts from our organization's Center For Excellence in Pediatric Resuscitation (CEPR).
Evaluation:
During the two yrs at our location we have had 8 events. Mock Code events occur quarterly. Debriefing occurs after each event (actual or mock). Staff reports an increased comfort level due to initial training & continued mock code events. All patients were stable at time of transport to a hospital.
Implications for Practice:
Utilization of experts in the area of simulation to provide a safe setting for practicing new skills. Advance planning & discussions with staff to allay fears. Continuing hands-on staff education with the use of mock codes and de briefings after any event.