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Does Simulation Training in Obstetric Code Blues Help Responders Identify Members of a Code Team? FREE TO VIEW

Adan Mora, MD; Avery Smith, MD; Shawna Robertson, BSN; Christine Renfro, BSN; Cristie Columbus, MD
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Baylor University Medical Center, Dallas, TX

Chest. 2015;148(4_MeetingAbstracts):474A. doi:10.1378/chest.2270130
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SESSION TITLE: Process Improvement in Obstructive Lung Disease Education, Pneumonia Readmissions and Rapid Response Systems I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Code blues are best executed when identification (ID) of each participant is clear. At our institution, codes follow a uniform layout allowing non-verbal cues to identify different members and their assigned roles. This layout was modified for obstetric (OB) codes.

METHODS: Healthcare workers responding to OB codes at Baylor University Medical Center (BUMC) in Dallas, Texas, underwent simulation training using Gaumard Scientific's Birthing Simulator, NOELLE (mimicked cardiac arrest and cesarean delivery). Pre-training assessment to identify code team members was done via an anonymous survey and quiz. Participants were shown a picture of a typical OB code set up including emergent delivery and asked to identify key code team members. Simulation of a mock code was completed followed by a lecture detailing code execution with use of verbal and non-verbal cues, ideal layout of code team members and their respective roles. A modification of the BUMC code layout was taught and participants repeated a mock code encouraged to use the new code layout. An anonymous survey and quiz were repeated.

RESULTS: 50 participants completed training/assessments. Pre-training, only 32% reported that they could identify code team members upon walking into an OB code. Post-training, 94% reported an ability to identify members of a code team and 88% thought that they could identify them upon walking into an OB code. Roles tested for ID accuracy were code captain (pre-training ID 48%; post-training ID 90%), recorder (pre-training ID 54%; post-training ID 90%), lead OB surgeon (pre-training ID 59%; post-training ID 93%), anesthesia/airway (pre-training ID 72%; post-training ID 85%), scrub tech (pre-training ID 15%; post-training ID 63%), chest compression team member (pre-training ID 27%; post-training ID 75%), crash cart RN (pre-training ID 56%; post-training ID 68%), defibrillator administrator (pre-training ID 88%; post-training ID 93%), drug administrator (pre-training ID 48%; post-training ID 65%). The largest improvement in ID was scrub tech (48%), chest compression team member (48%) and code captain (42%).

CONCLUSIONS: Assessment demonstrated an improvement in participants ability to identify OB code team members both subjectively by self report and objectively by quiz ID.

CLINICAL IMPLICATIONS: OB codes, especially when delivery of a baby is anticipated, require a modification in standard code execution. Implementation of a standard layout can help provide non-visual cues to better facilitate these codes.

DISCLOSURE: The following authors have nothing to disclose: Adan Mora, Avery Smith, Shawna Robertson, Christine Renfro, Cristie Columbus

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