Each year, nearly 300,000 lives in the United States are impacted by in-hospital cardiac arrests (IHCAs), with a staggering 80% mortality rate. Confidence plays a crucial role in effectively responding to these emergencies. Without it, uncertainty and hesitation can creep in, potentially costing precious lives.
Cardiac arrests are won or lost in the first few minutes. The chances of survival from a cardiac arrest drop by 10% with each passing minute without CPR. Nurses, who are often the first to identify and respond to these critical situations, have the power to make a life-saving difference.
Let's come together to support and empower our nurses, equipping them with the confidence and skills they need to save lives in those crucial first minutes. The impact we make today can change the course of countless lives in the future.
What does it mean to have a Code Blue mindset?
There is an expectation from the community, families, and patients that nurses will confidently use their life-saving skills to resuscitate them if needed. Many hospital systems invest in extensive life support training that theoretically should build effective code teams and nurse self-efficacy.
However, successful completion of a life-support course does not guarantee participants will recall and apply the content during an emergency. Knowledge acquired from Basic Life Support (BLS) courses deteriorates as soon as two weeks after course completion.
Emergencies initiate the fight or flight response causing many nurses to feel anxious, confused, and fearful, leading to immobilization. In-hospital first responders regardless of experience, often hesitate to initiate CPR and perform defibrillation.
CodePRep is an evidence-based, innovative triage-track and trigger system. The program combines BLS skills with unit-based, hands-on resuscitation drills that develop skill mastery and confidence. Most staff have never handled the crash cart, touched the defibrillator, are aware of the analyze function, put on defibrillation pads, opened the bag-mask device, or taken the backboard off the code cart. Implementation of CodePRep will allow interprofessional practitioners the chance to enhance their skills, increase their self-efficacy, and ultimately save more lives.
The Purpose of CodePRep is to Empower Nurses
The purpose of my Doctorate of Nursing Practice (DNP) project was to improve nurse and interprofessional perceived self-efficacy during in-hospital cardiac arrest. CodePRep is a continuous unit-based resuscitation program used in conjunction with BLS courses.
The system is designed to:
Improve CPR quality
Defibrillate in the first few minutes before the code team arrives if needed.
The goal is to apply a systems approach, providing perpetual standardized education. One of the most common misconceptions of in-patient nurses is they must be proficient in cardiac rhythms and Advanced Cardiac Life Support (ACLS) to be helpful in a code.
This perception can cause a less than desirable emergency response leading to failure to rescue (FTR). FTR is a clinician’s inability to save a hospitalized patient’s life when complications develop that were not present on admission. It is important for healthcare practitioners to realize they do not have to know everything. I propose that it is the basics, CPR and early defibrillation that win or lose a code. We cannot be distracted by advanced measures when the basics have not been performed.
Having a Code Blue mindset means being mentally and physically prepared to respond to a cardiac arrest or other medical emergency.
It involves having the necessary knowledge, skills, and confidence to take immediate and effective action, as well as being proactive and organized in a high-stress situation. A Code Blue mindset also includes a commitment to ongoing learning and improvement, to enhance resuscitation efforts, quality, and outcomes.
CodePRep addresses the problem that nurses and other healthcare professionals often lack sufficient hands-on practice to develop confidence and competence in emergency resuscitation situations. This can lead to delays in response times, ineffective CPR, and poor patient outcomes.
CodePRep provides evidence-based strategies, skills mastery, and team-based drills to empower healthcare teams to work at the top of their licensing and training, reducing hospital mortality rates and improving patient outcomes. By instilling a code blue mindset and standardizing unit-based resuscitation drills, CodePRep ensures that healthcare professionals are well-prepared and confident to respond quickly and effectively in high-stress resuscitation situations.
Somewhere along the way, the in-hospital community decided that only the nurse supervisor would handle the crash cart.
How is anyone supposed to be confident when they rarely if ever handle the equipment?
Any health care provider that holds a BLS card may participate in CodePRep drills. Hospital healthcare providers must be empowered; their BLS skills can be the difference between life or death. Nothing compares to high-quality, hands-on practice creating a strong foundation. The greater nurses and interprofessional staff perceive their self-efficacy with basic code skills; the quicker they are likely to initiate CPR, defibrillate and possibly save a life.
Dr. Susan Davis
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