In Med-Surg Telemetry Units, the management and outcomes of a Code Blue (cardiac arrest or medical emergency) event rely, among other processes, on clear role delineation to improve communication and team dynamics. Many nursing units still operate without clear role delineation during a Code Blue response. This lack of defined roles can lead to confusion, delays in life-saving interventions, and poor patient outcomes.
Racquel Agamata MSN, RN, PCCN, Nursing Professional Development Specialist, conducted an evidence-based practice (EBP) project to inquire on the evidence behind assigning Code Blue role delineation before the shift change, comparing it to the current practice where roles are not pre-assigned in Med-Surge Telemetry Units.
Clinical Question
To define the scope of literature search, the PICO question was “How does role delineation (role assignment) at the beginning of a shift affect the efficiency of Code Blue response in a Med-Surg Telemetry Unit compared to no role assignment?
Search Strategy
To gather relevant evidence, an organized search strategy was employed across multiple databases such as PubMed, Ovid, CINAHL, Cochrane Database using the search terms Code Blue, Role Assignment, Role Delineation, Cardiac Arrest, Efficiency in Emergency Response. Search Techniques includes Keyword, Title, MeSH Terms, Reference Mining. A total of 7 articles were reviewed, all included in the body of evidence for analysis.
Evidence Synthesis
The literature review consistently supports the idea that role delineation improves team efficiency during Code Blue events. The following key findings emerged from the evidence:
- Clarity and Efficiency: Pre-assigned roles eliminate confusion, allowing team members to act immediately without delays in task allocation.
- Enhanced Communication: Role delineation streamlines communication, enabling quicker decisions and more efficient interventions.
- Timely Interventions: Assigning roles ensures critical tasks like airway management, CPR, and medication administration are performed promptly.
- Improved Coordination: Clear roles improve team dynamics, maximizing skill utilization and task execution efficiency.
Practice Recommendations
Based on the evidence reviewed, several practice changes are recommended to improve Code Blue response efficiency:
- Pre-Assigned Roles: Assign roles during shift handoff to ensure preparedness.
- Color-coded systems: Use visual cues for quick role identification.
- Staff Engagement: Involve team members in the role assignment process.
- Equipment Readiness: Ensure crash carts and medications are easily accessible.
- Ongoing Education: Train staff on role delineation and Code Blue protocols.
- Mock Drills: Conduct regular practice drills with post-event critiques.
- Feedback Loops: Gather staff input to refine the process.