The perioperative units at an academic medical center have seen an increase in patient acuity and surgical case volume over the years. Although cardiopulmonary arrest (Code Blue) events remains rare in those units, the trend of increased patient acuity and sub-optimal Basic Life Support (BLS) skills among healthcare providers prompted the creation of this program. Literature supports the need for review and practice of Code Blue skills during the two year certification window as skill can decay as soon as two weeks. The goal of this process improvement project was to create a program that increases healthcare providers’ competency in BLS skills in compliance with American Heart Association (AHA) guidelines in perioperative units; from pre-anesthesia clinic to inpatient surgical units. AHA has been collaborating with multiple international agencies to bring science to save lives by researching and educating across the globe.
Methods:
A gap analysis indicated a need for a supplemental education and practice for Registered Nurses (RNs) and Patient Care Assistants (PCAs) to increase their confidence and skills in the Code Blue scenarios. Literature notes that healthcare facilities need to create a robust Code Blue refresher program to bridge the gap between re-certifications as the skills and knowledge of participants sharply decreases over time. BLS workshops for acute care units and Advanced Cardiac Life Support (ACLS) workshops for critical care units were offered over three months. Workshops addressed key aspects such as medication administration, teamwork, hands-on practice of ventilation and compression skills, mock Code Blue demonstrations by the instructors, and allowed for participation in in-situ mock Code Blue drills. Debriefing was performed after each intervention where participants gathered, analyzed, and provided self-reflection regarding their experience.
Results:
A fifteen-item BLS skill evaluation and two-item Likert scale self-efficacy survey were used to measure the effectiveness of the program to determine healthcare providers’ BLS skill and confidence. The performance evaluation showed an increase in chest compression compliance with AHA guideline from 49% to 91% and effective ventilation skill from 33% to 80%. Confidence increased from 4.16 to 4.34 out of 5.0.
Conclusion:
The addition of a cardiopulmonary resuscitation skill program in between ACLS and BLS re-certification provides hands on experience for healthcare providers. The program increased confidence and retention of vital skills to save patients’ lives, resulting in improved patient outcomes worldwide.