Öz
Amaç: Hastanemizde etkinleştirilen mavi kodların özelliklerini belirlemek ve mavi kod ekibinin performansını iyileştirmeye yönelik önerilerde bulunmaktır.
Gereç ve Yöntem: Üçüncü basamak bir hastanede, 4 yıllık bir dönem içindeki gerçekleşen mavi kod çağrıları hastane veri tabanından toplanmıştır. Mavi kod çağrılarının sonuçları ve bu ekibinin performansı kaydedilmiş ve yıllara göre karşılaştırılmıştır. Ayrıca, mavi kod ekibinin başarısı ile ilgili faktörler de araştırılmıştır.
Bulgular: Çalışma süresi boyunca toplam 2527 mavi kod çağrısı kaydedilmiştir. Hatalı mavi kod çağrılarının oranı % 3,7'dir. Gerçek mavi kod çağrılarına dair sonuçlar incelendiğinde, kardiyopulmoner resüsitasyon sonrasında toplam 1187 hastanın eks olduğu görülmüştür. “Çalışma saatleri içindeki" (08: 00-17: 00) çağrı sayısı ile karşılaştırıldığında “çalışma saatleri dışında" (17:00-08:00) alınan çağrıların sayısının anlamlı olarak daha yüksek olduğu tespit edilmiştir. 2018'de verilen yanlış kodların sayısı 2016 ve 2015 yılları ile karşılaştırıldığında anlamlı derecede daha yüksek bulunmuş, 2018'de gerçekleşen ölüm oranının da diğer yıllara göre istatistiksel olarak daha yüksek olduğu tespit edilmiştir.
Sonuç: Kurumumuzdaki mavi kod çağrılarının oranı önemli ölçüde artış eğilimi göstermektedir. Mavi kod çağrılarındaki bu artışla başa çıkabilmek için, özellikle mesai saati dışındaki zamanlarda mavi kod ekibi hem personel hem de eğitim faaliyetleri açısından takviye edilmelidir.
Anahtar Kelimeler
Kaynakça
- Referans1. Ece Y, Ünlüer EE, Erenler AK, et al. Evaluation of characteristics and clinical outcomes of patients with cardiac arrest. Journal of Academic Emergency Medicine 2017;16:79. Referans2. Bakan N, Karaören G, Tomruk ŞG, et al.Mortality in Code Blue; can APACHE II and PRISM scores be used as markers for prognostication? Ulus Travma Acil Cerrahi Derg 2018;24:149-155. Referans3. Eroglu SE, Onur O, Urgan O, et al. Blue code: Is it a real emergency? World J Emerg Med 2014;5:20-3. Referans4. Nallamothu BK, Guetterman TC, Harrod M, et al. How Do Resuscitation Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest Succeed? A Qualitative Study. Circulation 2018;138:154-163. Referans5. Abella BS, Kleinman ME, Edelson DP, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:417–35. Referans6. Vindigni SM, Lessing JN, Carlbom DJ.Hospital resuscitation teams: a review of the risks to the healthcare worker. J Intensive Care 2017;5:59. Referans7. Saghafinia M, Motamedi MH, Piryaie M, et al. Survival after in-hospital cardiopulmonary resuscitation in a major referral center. Saudi J Anaesth 2010;4:68–71 Referans8. Villamaria FJ, Pliego JF, Wehbe-Janek H, et al. Using simulation to orient code blue teams to a new hospital facility. Simul Healthc 2008;3:209–16 Referans9. Field JM, Hazinski MF, Sayre MR, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122:S640–56 Referans10.Adamski J, Nowakowski P, Goryński P, et al. Incidence of in-hospital cardiac arrest in Poland. Anaesthesiol Intensive Ther 2016;48:288-293. Referans11. Girotra S, Nallamothu BK, Spertus JA et al. Trends in survival after in-hospital cardiac arrest. N Engl J Med 2012;367:1912−20. Referans12. Möhnle P, Huge V, Polasek J, et al. Survival after cardiac arrest and changing task profile of the cardiac arrest team in a tertiary care center. ScientificWorldJournal 2012;2012:294512 Referans13.SK Pattnaik, B Ray, J Nayak, A Prusty, et al. Code blue protocol: observation and analysis of results over last 3 years in a new tertiary care hospital. Intensive Care Med Exp 2015;3:A205. Referans14.Risaliti C, Evans K, Buehler J, et al.Decoding Code Blue: A process to assess and improve code team function. Resuscitation 2018;122:e15-e16 Referans15. Mendes A, Carvalho F, Dias C, et al. In-hospital cardiac arrest: factors in the decision not to resuscitate. The impact of an organized in-hospital emergency system. Rev Port Cardiol 2009;28:131–41 Referans16. Peberdy MA, Ornato JP, Larkin GL, et al; National Registry of Cardiopulmonary Resuscitation Investigators. Survival from in-hospital cardiac arrest during nights and weekends. JAMA 2008;299:785–92. Referans17. Sodhi K, Singla MK, Shrivastava A. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital. Indian J Crit Care Med 2011;15:209–212 Referans18.Oh TK, Park YM, Do SH, et al. ROSC rates and live discharge rates after cardiopulmonary resuscitation by different CPR teams - a retrospective cohort study. BMC Anesthesiol 2017;17:166. Referans19. Devita MA, Bellomo R, Hillmann K, et al. Findings of the first consensus conference on medical emergency teams. Crit Care Med 2006;34:2463-78. Referans20. Baydın A, Duran L, Senguldur E, et al. Evaluation of Usefulness of Cardiopulmonary Resuscitation Education on Public Health Physicians. JCEI 2017;8:110-3 Referans21.Sahin KE, Ozdinc OZ, Yoldas S, et al. Code Blue evaluation in children's hospital. World J Emerg Med 2016;7:208-12. Referans22.Cheng A, Nadkarni VM, Mancini MB, et al.Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association.Circulation 2018;38:e82-e122. Referans23. Price JW, Applegarth O, Vu M, et al.Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Can Med Educ J 2012;3:e4-e20. Referans24.Williams KL, Rideout J, Pritchett-Kelly S, et al.Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses.Cureus. 2016;8:e938.
Öz
Purpose: To
determine characteristics of code blue activations in our hospital and make
suggestions to improve the performance of code blue team.
Materials and Methods: In a tertiary care hospital,
code blue activations in a 4-year period were collected from hospital database.
Outcomes of code blue calls and the performance of code blue team were recorded
and compared according to years. Also, factors associated with code blue team
success were investigated.
Results:
A
total of 2527 code blue calls were recorded during the study period.The
proportion of false code blue calls was 3.7%. When outcomes of true code blue
calls were investigated, a total of 1187 patients have died following
cardiopulmonary resuscitation. Number of calls in “off times (17:00-08:00)” was significantly higher when
compared to those in “working hours (08:00-17:00)”. Number of false codes were
significantly higher in 2018 when compared to 2016 and 2015.In 2018, mortality
rate was statistically higher when compared to other years.
Conclusion: Code blue calls tend to
increase significantly in our facility. Code blue team, particularly in
off-times, must be strengthened with both personnel and training activities in
order to deal with increasing code blue calls.
Anahtar Kelimeler
Kaynakça
- Referans1. Ece Y, Ünlüer EE, Erenler AK, et al. Evaluation of characteristics and clinical outcomes of patients with cardiac arrest. Journal of Academic Emergency Medicine 2017;16:79. Referans2. Bakan N, Karaören G, Tomruk ŞG, et al.Mortality in Code Blue; can APACHE II and PRISM scores be used as markers for prognostication? Ulus Travma Acil Cerrahi Derg 2018;24:149-155. Referans3. Eroglu SE, Onur O, Urgan O, et al. Blue code: Is it a real emergency? World J Emerg Med 2014;5:20-3. Referans4. Nallamothu BK, Guetterman TC, Harrod M, et al. How Do Resuscitation Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest Succeed? A Qualitative Study. Circulation 2018;138:154-163. Referans5. Abella BS, Kleinman ME, Edelson DP, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:417–35. Referans6. Vindigni SM, Lessing JN, Carlbom DJ.Hospital resuscitation teams: a review of the risks to the healthcare worker. J Intensive Care 2017;5:59. Referans7. Saghafinia M, Motamedi MH, Piryaie M, et al. Survival after in-hospital cardiopulmonary resuscitation in a major referral center. Saudi J Anaesth 2010;4:68–71 Referans8. Villamaria FJ, Pliego JF, Wehbe-Janek H, et al. Using simulation to orient code blue teams to a new hospital facility. Simul Healthc 2008;3:209–16 Referans9. Field JM, Hazinski MF, Sayre MR, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122:S640–56 Referans10.Adamski J, Nowakowski P, Goryński P, et al. Incidence of in-hospital cardiac arrest in Poland. Anaesthesiol Intensive Ther 2016;48:288-293. Referans11. Girotra S, Nallamothu BK, Spertus JA et al. Trends in survival after in-hospital cardiac arrest. N Engl J Med 2012;367:1912−20. Referans12. Möhnle P, Huge V, Polasek J, et al. Survival after cardiac arrest and changing task profile of the cardiac arrest team in a tertiary care center. ScientificWorldJournal 2012;2012:294512 Referans13.SK Pattnaik, B Ray, J Nayak, A Prusty, et al. Code blue protocol: observation and analysis of results over last 3 years in a new tertiary care hospital. Intensive Care Med Exp 2015;3:A205. Referans14.Risaliti C, Evans K, Buehler J, et al.Decoding Code Blue: A process to assess and improve code team function. Resuscitation 2018;122:e15-e16 Referans15. Mendes A, Carvalho F, Dias C, et al. In-hospital cardiac arrest: factors in the decision not to resuscitate. The impact of an organized in-hospital emergency system. Rev Port Cardiol 2009;28:131–41 Referans16. Peberdy MA, Ornato JP, Larkin GL, et al; National Registry of Cardiopulmonary Resuscitation Investigators. Survival from in-hospital cardiac arrest during nights and weekends. JAMA 2008;299:785–92. Referans17. Sodhi K, Singla MK, Shrivastava A. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital. Indian J Crit Care Med 2011;15:209–212 Referans18.Oh TK, Park YM, Do SH, et al. ROSC rates and live discharge rates after cardiopulmonary resuscitation by different CPR teams - a retrospective cohort study. BMC Anesthesiol 2017;17:166. Referans19. Devita MA, Bellomo R, Hillmann K, et al. Findings of the first consensus conference on medical emergency teams. Crit Care Med 2006;34:2463-78. Referans20. Baydın A, Duran L, Senguldur E, et al. Evaluation of Usefulness of Cardiopulmonary Resuscitation Education on Public Health Physicians. JCEI 2017;8:110-3 Referans21.Sahin KE, Ozdinc OZ, Yoldas S, et al. Code Blue evaluation in children's hospital. World J Emerg Med 2016;7:208-12. Referans22.Cheng A, Nadkarni VM, Mancini MB, et al.Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association.Circulation 2018;38:e82-e122. Referans23. Price JW, Applegarth O, Vu M, et al.Code Blue Emergencies: A Team Task Analysis and Educational Initiative. Can Med Educ J 2012;3:e4-e20. Referans24.Williams KL, Rideout J, Pritchett-Kelly S, et al.Mock Code: A Code Blue Scenario Requested by and Developed for Registered Nurses.Cureus. 2016;8:e938.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Acil Tıp, Anesteziyoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Mayıs 2020 |
| Gönderilme Tarihi | 10 Aralık 2019 |
| Kabul Tarihi | 3 Şubat 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 13 Sayı: 2 |
Kaynak Göster
