Semester
Summer
Date of Graduation
2025
Document Type
Problem/Project Report
Degree Type
DNP
College
School of Nursing
Department
Anesthesiology
Committee Chair
Ann Hendrickson
Committee Co-Chair
Marian Longstreth
Committee Member
Kellon Smith
Committee Member
Pamela Frantz
Abstract
Background: The code documenter plays a crucial role in ensuring accurate, real-time documentation during Code Blue events, which is critical for patient care and compliance with established guidelines and protocols. However, nurses have reported discomfort with the Code Narrator tool in EPIC, which has hindered effective documentation during these high-pressure situations.
Purpose: The lack of comfort in using the Code Narrator tool has led to inconsistent and inaccurate documentation during Code Blue events, potentially impacting the effectiveness of the response and patient outcomes, such as the achievement of return of spontaneous circulation (ROSC).
Intervention: An educational competency program was implemented, incorporating high-fidelity simulation training to improve nurse comfort with the Code Narrator tool. Two pilot units received training and participated in mock Code Blue events designed to improve comfort and documentation accuracy. The intervention aimed to enhance nurse comfort, improve documentation quality, and increase ROSC rates post-Code Blue.
Methods: A retrospective chart review of Code Blue events assessed baseline documentation practices, while a staff questionnaire evaluated nurse comfort with the Code Narrator tool and identified areas for further education and support.
Results: Post-intervention analysis demonstrated significant improvements in nurse comfort with both the code documenter role and with real-time documentation. Comfort levels increased by 119.5% for nurse comfort within the documenter role, surpassing the projects 50% target. Comfort with real-time documentation also improved by 45.3%, exceeding the 30% goal. However, the targeted 15% increase in the proportion of patients achieving ROSC for at least 20 minutes post-code was not met, with the post-implementation ROSC rate remaining at 75%. Despite this, improvements in medication administration adherence were observed, through pulse check delays persisted.
Conclusion: This quality improvement initiative improved nursing comfort in the code blue documenter role, enhancing documentation accuracy, team communication, and patient outcomes. The initiative emphasized the importance of ongoing training and support for sustained impact across healthcare settings.
Recommended Citation
Benvenuto, Stefanie A., "Code Blue Narrator Documentation: An Evidence Based Quality Improvement Initiative" (2025). Graduate Theses, Dissertations, and Problem Reports. 12938.
https://researchrepository.wvu.edu/etd/12938