When a patient goes into cardiac or respiratory arrest, a team of healthcare providers has mere minutes to assemble at the bedside to perform resuscitation. Every second counts during such a crisis, and a rapid response is critical to the patient’s survival. Called Code Blue, this type of medical emergency occurs fairly often in hospitals and staff must be fully prepared to react quickly.
A new simulation program at Southern California Hospital at Culver City is helping clinicians better prepare for a Code Blue by putting their skills to the test. In the fall of 2020, the clinical education department has held mock Code Blue drills for different hospital units that mimic a real medical emergency. The program gives Code teams the chance to practice and expand their knowledge, while building up their self-confidence in a safe and controlled environment with no risk to patients.
“These simulations aim to improve the speed and quality of the code blue response by staff and, in the end, the patient benefits from us doing these drills,” said Jessica Dela Rosa, clinical education director. “When the real event happens, they know exactly what to do. It’s like building muscle memory.”
How the Drills Work
In the last few months, Dela Rosa and her colleagues have performed three Code Blue drills so far, with a goal to do one or two every month. First, they sneak into the unit being tested with a mannequin in tow and lay it on an empty bed. They activate the call bell, which sounds an alarm throughout the whole unit indicating a Code Blue. At this point, the nurses and other healthcare providers are unaware that this is a mock code and not a real emergency.
The staff arrives at the bedside and begins to follow the Code Blue protocol, which can include cardiopulmonary resuscitation, defibrillation and other interventions. An educator stands by and gives the team members an evolving storyline, throwing various curveballs to challenge their knowledge and skills. Afterward, a debriefing takes place to evaluate the team’s performance and assess any gaps in practice.
“The educator will outline what they did well, along with anything that needs improvement,” said Dela Rosa. “That’s the real learning opportunity, because staff will take that moment to ask questions and get clarifications. Mistakes are OK, as long as it helps staff do better in a real-life scenario.”
Studies have found that effective Code Blue teams are associated with improved patient outcomes. An ideal team assembles quickly, administers high-quality CPR to the patient, and has competent leadership in place. Participating in mock drills on a regular basis is a proven way to boost performance in these areas.
All units at Southern California Hospital at Culver City — including both day and night shifts—take part in Code Blue simulations, which are tailored to the specific unit being tested. For instance, the three mock codes performed in the last few months featured scenarios relevant to the post-anesthesia care unit, cath lab and medical-surgical unit.
In addition, the clinical education department works closely with a physician who support all Code Blue simulations. Dr. Brittany Brinley, a board-certified internist, is present during all simulations to lend her expertise.
“Mock Code Blues train the staff to be able to react efficiently in a life-threatening situation where every second counts; it’s like a fire drill,” Dela Rosa pointed out. “Ultimately, practice makes perfect, and performing regular simulations in a controlled environment can be beneficial for staff and lead to improved patient outcomes.”