CHAPTER ONE
1.1. Introduction
Code blue team whose trained well and have competent members saves patients lives quickly and effectively. Through early recognition and intervention by high- performance teams thereby reversing clinical death (Cynthia et al., 2014). By respond to victim who has signs of cardiac arrest (unresponsive , no breathing and no pulse ). cardiac arrest identified as heart stop circulating blood throughout the body , because of heart failure to contract effectively causes heart stop beating and not pumps blood to the body. Subsequently, the patient doesn't have pulse and become unconscious ; If no resuscitation intervention attempts to return of spontaneous blood circulation,and palpable
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Intervention Details
The organization development project plan to an implement evidence based best practice of mock simulation training to achieve the related aim and objectives of the project. The plan to be conduct over six month period training on Weekly basis on any given day or shift to the healthcare providers who might encounter a cardiac arrest in various units throughout the hospital.
The mock codes to be conduct within actual units in the hospital, to create a realistic environment and replicate the steps of resuscitation events with surprise mock codes (simulation) scenario by practice on high – fidelity simulation manikins to provide a realistic mock simulation scenario.
"Mock Code" training focusing on the staff in their area: the primary nurse starting the scenario by recognition the cardiac arrest and activate the code, calling for additional help, starting high-quality chest compression, using AED. The stimulated code scenario lasted 10 minutes followed by 15 minutes debriefing.
Debriefing provide an opportunity for feedback to enhance and develop clinical resuscitation skills in emergency setting and compliance with AHA standards and quality core measures of high quality performance of resuscitation . The change model propose for implementation plan of change is( health service executive) HSE model stages (HSE ,
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Gantt chart was prepared with listed tasks in a change project against a timeframe (Appendix 2). The Gantt chart consist of project stage and sub-stage starting from initiation, planning implementation and evaluation phases.
1.7. Change agent Role and the Team in the project.
Critical care in MQ hospital, specifically cardiac intensive care unit ,where a code blue team established aim to respond to cardiac arrest call in any unit or clinic or department in the organization . Code teams generally face a series of events and circumstances. So accordingly, the staff should have mandatory training for healthcare provider of standardized life support courses including ; basic life support (BLS) ,advanced cardiovascular life support (ACLS) .
Since, I am CICU charge nurse and one of code blue member and ACLS instructor planning to work as trainer and coach for mock code proposal project. With cooperation of an in-service education and discussing the objectives of the project that desire to be achieve with critical care unit manager and code blue committee. In addition to inform senior management for planning and implementation of the project by building commitment and getting approval
Across the nation many nursing programs are facing clinical site shortages for their students. The hardest hit population is the license vocational nursing (LVN) students. Many hospitals are trending toward achieving “Magnet Status” for their institutions. Therefore, LVN students are no longer allowed to complete their clinical training in several hospitals. This action forces many nursing programs to seek alternative methods of clinical instruction. In years past simulation training was used as an aid to facilitate learning. Today, for many nursing programs scenario based simulation is the only option for learning patient care.
Basic life support (BLS) is a skill that many people in the community are lacking. Nearly 400,000 out-of-hospital cardiac arrests occur annually in the United States (American Heart Association, 2012), and of this 89% of the people die because they did not receive immediate CPR by a bystander (American Heart Association, 2012).
Yet, he suffered an event of ventricular fibrillation which he was shocked for, followed by a massive heart attack while unaccompanied at a restaurant. Upon arrival at the Southcoast Hospital, he went into ventricular tachycardia in the Emergency Room and was shocked a second time. According to the Southcoast Critical Care Manual, these events are part of the inclusion criteria for therapeutic hypothermia after cardiac arrest. He fits the first inclusion criteria listed which is: cardiac arrest with return of spontaneous circulation (ROSC) with initial rhythm of ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity or asystole. The protocol is provided at the end of the paper.
There are events, subtle or otherwise, leading up to a critical change in health status. As nurses at the bedside, we must have strategies and protocols implemented in order to monitor changes in vital signs and trends leading towards a cardiac, respiratory, or neurologic event. In a hospital setting, patients are monitored for changes in condition, whether it be improvement or deterioration, allowing clinicians to decide the course of action to follow in their care.
(2011). The 'Standard' of the 'Standard'. PHTLS: Pre-Hospital Trauma Life Support (Military version: 7th ed.). St. Louis, MO, USA: Elsevier.
Specifically, in the academic settings, nurse educators experienced in the use of medical simulation can enhance “student’s nursing education with interactive practice sessions (Aebersold & Tschannen, 2013).” As a teaching methodology, “a clinical simulation experience is an active event for students to be immersed in realistic clinical environments or situations. Students must incorporate critical thinking and decision-making skills using the nursing process. (Virginia State Simulation Alliance, 2013).” To understand the importance of skilled clinical nurse educator’s role, a case study will be presented using a simulation lab experience conducted with a student nurse. This simplified simulation case study will identify and define the steps of the nursing process and the student’s progression through them. Also, it will identify the value of a nurse educator and the responsibilities undertaken in strengthening the competencies of the student involved.
According to the American Heart Association (AHA), over 350,000 people experience cardiac arrest outside of hospitals every year. Every second that a heart doesn’t beat dramatically decreases a person’s survival rate. CPR is a simple way to keep blood pumping through the body until medical personnel arrive. Only 46 percent of cardiac arrest victims receive CPR, primarily because most bystanders don’t have the proper training. Fortunately, schools are in a unique position to greatly improve that statistic.
H. Al-Elq, (2010),Simulation-based medical teaching and learning Simulation-based medical teaching and learning Family Community Med.
The rapid response team (RRT) main purpose is to save lives and decreases the risk for harm by providing care to patients before a respiratory or cardiac arrest occurs (Ignatavicius, 2013). All facilities have different protocols when it comes to activating the Rapid Response Team and Code Team. The rapid response team are on-site and always available, the rapid response team usually includes ICU nurses, intensivist, respiratory therapist, and a hospitalist. In most cases a nurse will call for the rapid response team, but the patient’s family also have the authority to activate the rapid response team. A nurse may activate the rapid response team if the patient has an acute change in heart rate, acute change in systolic blood pressure, acute change in respiratory rate, acute drop in O2 saturation, acute change in mental status, major drop in urine output (Resuscitation Central , 2010).The rapid response team does not replace the Code Team, who responds to a client who is actively in cardiac or respiratory arrests.
With the proper training and adoption of EHR, Bellevue will not only improved their system of billing and collections, but optimized quality of care for patients through its simulation training programs utilized by its inter-professional teams of physicians, nurses and pharmacists who are able to obtain the clearest possible picture of the patients’ circumstances while nurses are able to review vital signs, pharmacist reviewed medication histories and physician
The practice of nursing has many concepts worth exploring to contribute to a better practice in profession and education of future professionals. How new nurses are educated is particularly important because patient wellness, experience, and satisfaction is depended on nursing care. The process of concept analysis and personal philosophy reflection can assist the educator in finding innovative and meaningful ways to educate the next generation of nurses. The purpose of this paper is to review the concept of high-fidelity simulation education and apply this method to personal education philosophy with the intent of understanding how evidence-based practice can influence education. Concept Analysis: Simulation Education Concept analysis
With this study it was proven how much of a difference high quality CPR increased survival ability of sudden cardiac arrests. Being able to perform high quality CPR is the first step in successful
There are many members of the inter-professional team, all of which are contributing to the healthcare of acute and critically ill patients. Every member of the team has had education and obtained a license of practice compatible to their level of knowledge (Prater, Fundamentals of Nursing, 2013). As a practical nurse you need to be mindful of your scope of practice in relation to registered nurses, certified nurses’ assistants and other healthcare professionals. With so many different people involved in the immediate care of a patient, there is always the possibility of a mix up. The purpose of this paper is to help differentiate between the roles of the healthcare staff, which will in turn help develop a knowledge base for prioritizing care;
A study of gift and estate tax issues There are some issues in gift and estate tax in the United States, especially for those who have a lot of money to give to their relatives or other people before they die. Before going into detail about those issues, we should understand the meaning of a gift and estate tax. According to Internal Revenue Service, a gift is “Any transfer to an individual, either directly or indirectly, where full consideration (measured in money or money’s worth) is not received in return.” The gift tax is a tool that will stop people from giving away all their assets before death thus avoiding having to pay estate tax. Most people will not have to pay estate tax as they do not have the required assets; however, some people
In the 1990s David Gaba lead a group at Stanford University and supported simulation-based training in the handling of anesthesia crises by utilizing staff resource managing bases from aviation ( A,A1,A2). This method is nowadays the main model for crisis resource managing training in all medical fields and globally has become known as an efficient method for team training. The use of simulation has confirmed to be efficient and preferable to other training methods for a wide extent of skills such as collaboration in the team and technical skills (B1-B5). The definition of simulation by the Institute of Medicine is: emulating a situation through something similar.