Revised Code Blue Record and Get With the Guidelines-Resuscitation

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Revised Code Blue Record and Get With the
Guidelines-Resuscitation

• Justin Hamilton, BSN, RN
• Aultman Hospital
• Critical Care Coordinator

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Information and Instructions

• Completion of this Learning Module is mandatory
  for RNs and LPNs within Aultman Hospital who
  currently utilize the Code Blue Record to
  document a Code Blue event.
• Read the information contained in this learning
  module.
• Read and sign the Accountability Form entitled
  Revised Code Blue Record and Get With the
  Guidelines-Resuscitation
• Completion Deadline June 15, 2012

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Objectives

• Objectives At the end of this learning module,
  the nurse should be able to
• Identify the documentation revisions made to the
  Code Blue Record.
• Discuss the intent American Heart Association
  (AHA) Get With the Guidelines-Resuscitation
  (GWTG-R) Program.

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Code Blue Record Revision
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What was changed on the Code Blue Record?

• Four Additions Under Onset Information
• Code Status Prior
• Blank to be filled in by Recorder
• Hospital-wide resuscitation response active
• Yes if code was paged overhead
• No if code was not paged overhead (ICU situations
  where physician is present and able to intubate
  patient or physician present and patient
  previously intubated)
• Height
• Blank to be filled in by Recorder
• Monitoring at onset
• ECG (Telemetry monitor or ICU monitor), Pulse
  oximeter, or Apnea, these boxes should be checked
  if patient was ordered to have these monitors in
  use

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Changes at a glance
Indicate Code Status Prior to the Code Event.
Was code paged overhead?
Fill in the patients height.
Indicate any monitoring that was ordered prior
to the initiation of the code.
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Code Blue Record Addendum

• Form 399A will be an addendum sheet that will be
  formatted identical to the bottom box on the
  present Code Blue Record.
• This page will be utilized to document once the
  initial spaces are filled in.
• The Recorder then must fill in the Page_of_
• section at the bottom of all forms.

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Form 399A Code Blue Record / Vital Signs
AULTMAN CODE BLUE RECORD
VITAL SIGNS
PATIENT LABEL
  VITAL SIGNS
KEY Pulse C Compressions
Resps B Bagged  
TIME Pulse Resps SAT BP Rhythm Defibrillator (joules) Levophed Mcg/min Dopamine (Mcg/kg/min Amiodarone Mg/min Other IVF _______ CODE EVENTS (labs, line insertion, etc.)
                         
                         
                         
                         
                         
                         
                         
                         
                         
                         
                         
                         


PROGESS NOTES
Form 399A (93412) R 05/12 White Copy Chart Yellow Copy Critical Care Coordinator PAGE ___ of ___
PROGRESS NOTES
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Why was the Code Blue Record Changed?

• The Code Blue Record was changed in preparation
  for the participation of Aultman Hospital in the
  American Heart Association (AHA) Get With the
  Guidelines-Resuscitation (GWTG-R) Program.
• The additional sections will allow for more
  efficient data entry into the GWTG-R database by
  Intensivist team nurses.

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What is GWTG-R?

• GWTG-R is a program that allows hospitals to
  enter and review arrest events.
• The participating hospitals can then make changes
  to ensure that they are providing the best
  possible outcomes for their patient populations.
• Individual hospital data can be compared to other
  similar facilities participating in the GWTG-R
  program.
• Participating hospitals will be eligible to
  receive Bronze, Silver, and Gold Awards based on
  the achievement of set outcomes.

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What is GWTG-R? CONTINUED

• Following the Code Blue event, the white copy of
  the Code Blue Record should be placed on the
  patients medical record.
• The yellow carbon copy of the Code Blue Record
  should be detached, placed in an envelop and sent
  to Medical Intensive Care or Justin Hamilton,
  Critical Care Coordinator through Interoffice
  Mail. (CCU nurses please note we have these
  envelopes on our code carts!!)

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GWTG-R Outcomes

• Hospitals must achieve 85 compliance in the
  following four outcomes to be recognized by the
  AHA for GWTG-R awards
• Time to first chest compressions lt 1 minute in
  adult and pediatric patients.
• Time to first shock lt 2 minutes for VF
  (Ventricular Fibrillation)/pulseless VT
  (Ventricular Tachycardia) first documented
  rhythm.
• Pulseless cardiac events monitored or witnessed
  at the time of arrest.
• Device confirmation of correct endotracheal tube
  placement (End Tital CO2 Cap or Capnometry device
  supplied with all endotracheal intubation trays
  presently on Code Carts).

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References

• All information pertaining to GWTG-R obtained
  from The American Heart Association web site
  http//www.heart.org/HEARTORG/HealthcareResearch/G
  etWithTheGuidelines-Resuscitation/Get-With-The-Gui
  delines-Resuscitation_UCM_314496_SubHomePage.jsp

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Questions / Contact Information

• For any questions please contact
• Justin Hamilton, BSN, RN
• Office Phone [phone]
• Email jhamilton_at_aultman.com

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Accountability Form

• After you have completely
• read and understand
• this material, please enter
• the Quiz section of Quia
• and complete the
• Accountability Form for
• Revised Code Blue Record and Get With the
  Guidelines-Resuscitation.