Implementation of Code Blue Role Assignments and Education for Emergency Room Nurses BACKGROUND The emergency room nurses lack supportive education and clear role assignments for code blue or cardiac arrest response. The lack of educational support and clear roles can cause delays in care and lead to poor patient outcomes. • The AHA states clear roles reduce delays in response to cardiac arrest.1 • A study showed improved outcomes identified with just one role pre-determined.2 • Clear roles during high stress events improve team communication, according to the AHA.1 METHODS • Lewins Change Theory provides the framework • Pre-survey of emergency room nurses • Educational PowerPoint presentation • Visual aide for pre-determined roles • Hands-on mock code event with pre-determined roles assigned. • Post-survey of emergency room nurses • Continued education in the form of mock codes. Student: Taresa Higbee, BSN, RN, MSN Student, CCRN Faculty: JoAnn Tolman, DNP-L, MSN-Ed, RN, CNE Content Expert: Amber Valline, MSN, BSN, RN INTERVENTIONS • Buy-in meetings with nurse managers, code committee, and emergency room nurses’ unit-based council. • Pre-survey on emergency room nurses to evaluate the code team dynamics. • Mandatory education for emergency room nurses responding to cardiac arrest events. • Process for charge nurse to pre-assign code team roles in the emergency room • Full mock code practice following education implementing pre-determined roles • Post-survey after education and mock codes to evaluate code team dynamics after implementation. • Ongoing implementation and reflection of change IMPACTS • This project is essential because mock codes will improve job satisfaction, decrease stress related to code blue events, support quality improvement around cardiac arrest, and support improved team function, as noted in high-performing hospitals.3 • With increased simulations, the support of clinical growth will rise, leading to improved adherence to the AHA algorithm.4, 5 • The addition of this education and hands-on skills will support the development of the nurse’s practice. When a nurse is more confident and competent it can positively impact their overall skills. 1,2,6 Image 1 Team Lead Supporting Physician REFERENCES 1. American Heart Association (2024). CPR and first aid. Retrieved October 3, 2024, from https://www.heart.org/ 2. O'Leary, A., Butler, P., & Fine, J. R. (2023). Dedicated chest compressor team: A quality improvement initiative to improve chest compression performance at in-hospital cardiac arrest events through quarterly training. Resuscitation Plus, 13, 100361-100361. https://doi.org/10.1016/j.resplu.2023.100361 3. Anderson, T. M., Secrest, K., Krein, S. L., Schildhouse, R., Guetterman, T. C., Harrod, M., Trumpower, B., Kronick, S. L., Pribble, J., Chan, P. S., & Nallamothu, B. K. (2021). Best practices for education and training of resuscitation teams for in-hospital cardiac arrest. Circulation Cardiovascular Quality and Outcomes, 14(12), e008587-e008587. https://doi.org/10.1161/CIRCOUTCOMES.121.008587 4. Chan, P. S., Greif, R., Anderson, T., Atiq, H., Bittencourt Couto, T., Considine, J., De Caen, A. R., Djärv, T., Doll, A., Douma, M. J., Edelson, D. P., Xu, F., Finn, J. C., Firestone, G., Girotra, S., Lauridsen, K. G., Kah-Lai Leong, C., Lim, S. H., Morley, P. T., International Liaison Committee on Resuscitation. (2023). Ten steps toward improving in-hospital cardiac arrest quality of care and outcomes. Resuscitation, 193, 109996. https://doi.org/10.1016/j.resuscitation.2023.109996 5. Pearson, D. A., Bensen Covell, N., Covell, B., Johnson, B., Lounsbury, C., Przybysz, M., Weekes, A., & Runyon, M. (2024). Effectiveness of teamfocused CPR on in-hospital CPR quality and outcomes. Resuscitation Plus, 18, 100620-100620. https://doi.org/10.1016/j.resplu.2024.100620 6. Eda, O. S., Maneval, R., & Myers, P. (2021). Incorporating rapid cycle deliberate practice cardiac arrest simulation program into nursing staff continuing professional development. The Journal of Continuing Education in Nursing, 52(6), 274-279. https://doi.org/10.3928/00220124-2021051406 Image 1 Pixabay (n.d.) Cpr [photograph]. https://pixabay.com/photos/cpr-resuscitation-emergency-9180856/ ER RN 1 ER RN 2 Compressor Airway: RT & MD Recorder Primary RN CN/Runner CONCLUSIONS • Implementing pre-determined roles and mock code education for emergency room nurses is a step toward improving team dynamics and patient outcomes during cardiac arrest events. • This project solves the current education and role assignment gaps while providing a structured and supportive environment for nurses to develop their skills • By using mock code scenario practice and incorporating continuous education, in addition to the current process of RQI, the facility can ensure that the staff are well-prepared to handle these critical situations, ultimately leading to better patient care and outcomes.