Background: The responsibility of nurses is early clinical deterioration and taking appropriate action. Knowledge and proficiency in Code Blue protocols come handy, which lacks in most nurses recognizing. Simulation-based learning plays a role in improving performance and confidence in handling such situations. This goal-based method of program evaluation aims to examine Code Blue training programs and compare them with current literature and established professional standards while assessing participants’ experience and change in knowledge to this educational method.
Materials and methods: Following ethical approval, a prospective interventional study was conducted in the simulation center of a private medical college in Mangalore on 65 nursing students.
A pretest was given to the participants on the day of the session to assess their baseline understanding followed by prebriefing, all previously having received didactic lectures on Code Blue protocol, crash cart, and cardiac arrest algorithms. They were divided into three batches and each batch performed on crash cart and cardiac arrest stations using an electrocardiogram simulator. A simulated drill was enacted by the faculty on managing a Code Blue event and a discussion was followed. Nurses underwent two simulated scenarios, shockable and nonshockable cardiac arrest algorithms, followed by debriefing. Posttest and feedback form was asked to be filled.
Results: A significant increase in mean% from pretest to posttest (55.69–77.33%) following simulated drills.
Conclusion: The use of simulation to train nurses in Code Blue scenarios records greater satisfaction and improvement in clinical reasoning, knowledge, and skills. Hence, the incorporation of simulation teaching in training of those involved in caring for high-risk patients is the need of the hour.
Ahern RM, Lozano R, Naghavi M, Foreman K, Gakidou E, Murray CJ. Improving the public health utility of global cardiovascular mortality data: the rise of ischemic heart disease. Popul Health Metr 2011;9(1):8. DOI: 10.1186/1478-7954-9-8.
Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, et al. CPR quality: Improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 2013;128(4):1–19. DOI: 10.1161/CIR.0b013e31829d8654.
Dwyer T, Mosel WL. Nurses’ behavior regarding CPR and the theories of reasoned action and planned behavior. Resuscitation 2002;52(1):85–90. DOI: 10.1016/s0300-9572(01)00445-2.
Kohn LT, Corrigan JM, Donaldson MS, editors. Institute of Medicine (US) Committee on Quality of Health Care in America. To err is human: building a safer health system. Washington (DC): National Academies Press (US); 2000. PMID: 25077248.
Okuda Y, Quinones J. The use of simulation in the education of emergency care providers for cardiac emergencies. Int J Emerg Med 2008;1(2):73–77. DOI: 10.1007/s12245-008-0034-2.
Gaba DM. The future vision of simulation in health care. Qual Saf Health Care 2004;13(Suppl. 1):i2–i10. DOI: 10.1136/qhc.13.suppl_1.i2.
Weller JM, Nestel D, Marshall SD, Brooks PM, Conn JJ. Simulation in clinical teaching and learning. Med J Aust 2012;196(9):594. DOI: 10.5694/mja10.11474.
Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 2011;306(9):978–988. DOI: 10.1001/jama.2011.1234.
Cook DA, Hamstra SJ, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach 2013;35(1):e867-e898. DOI: 10.3109/0142159X.2012.714886.
Cooper S, Kinsman L, Buykx P, McConnell-Henry T, Endacott R, Scholes J. Managing the deteriorating patient in a simulated environment: nursing students’ knowledge, skill and situation awareness. J Clin Nurs 2010;19(15/16):2309–2318. DOI: 10.1111/j.1365-2702.2009.03164.x.
Lindsey PL, Jenkins S. Nursing students’ clinical judgment regarding rapid response: the influence of a clinical simulation education intervention. Nurs Forum 2013;48(1):61–70. DOI: 10.1111/nuf.12002.
Liaw S, Chan S, Scherpbier A, Rethans J, Pua G. Recognizing, responding to and reporting patient deterioration: transferring simulation learning to patient care settings. Resuscitation 2012;83(3):395–398. DOI: 10.1016/j.resuscitation.2011.08.021.
Askew T, Trotter TL, Vacchiano S, Garvey P, Overcash J. Avoiding failure to rescue situations: a simulation exercise for oncology nurses. Clin J Oncol Nurs 2012;16(5):530–532. DOI: 10.1188/12.CJON.530-532.