Concept is to bring a multidisciplinary group rapidly to the bedside
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| Nurses checking the Code Neon supply cart prior to a simulation are, from left to right, Karen Smith, Mary Miller and Heather Scheidegg. Labor and Delivery is the first unit to conduct multidisciplinary, videotaped simulations live on the floor. |
York Hospital’s newest rapid-response team has been busy since its launch in mid-September. The Code Neon team for pregnancy-related emergencies has already responded to eight calls. As many as one in 50 pregnancies involve a serious complication.
“In a heartbeat it can change to an emergent situation,” said clinical nurse educator Jennifer Leash, RNC-OB. “Since we have a Level 3 NICU, a high-risk transfer unit and a trauma center, we do get more high-risk moms and babies.”
The team is ready on a 24/7 basis to handle emergency C-sections, cardiac arrest, post-delivery hemorrhaging, and any other critical problems that may arise.
“Code Neon is for any obstetrical emergency that occurs anywhere in the hospital, not just on Labor and Delivery,” explained Missy Garavente, M.D. “The concept is to quickly bring a multidisciplinary group rapidly to the bedside."
Even though an obstetrical rapid response team is a Joint Commission requirement, the group’s professional diversity sets it apart from others. Attending physicians, residents, nurses, and administrators from several different departments plan and train together.
Code Neon stemmed from emergency response research by clinical nurse educator Karen Smith, RNC-OB. Evidence-based medicine was used to begin training the team over the summer. Training included two full-scale simulations, which were held on Tower 4.
The Code Neon team collaborated with the medical code team and the NICU team to run codes just as they would occur in real time. The team also worked with the blood bank to incorporate MTP into hemorrhage emergencies, as this is a major cause of maternal mortality and morbidity.
Smith said Labor and Delivery is the first unit to conduct multidisciplinary videotaped simulations live on the floor. The simulations, the most recent in February, have attracted dozens of observers. A debriefing follows each simulation and systems are critiqued. Potential problems are identified and an action plan is developed.
The process has helped identify supplies and medications that were needed on the cart. The team now has several fully stocked rapid-response carts with medications to take along on an emergency call. During every shift, nurses from Labor and Delivery and Tower 4 are designated for Code Neon.
“We have a large pool of experienced nurses to draw on, which is a big step in building a successful team,” Smith noted.
When someone dials 66 to report an obstetrical emergency, the Code Neon nurses and other team members receive a mass page. All critical team members now also carry phones to promote direct communication.
A recent Code Neon call involved a pregnant trauma patient who required an immediate C-section. The team had practiced a similar simulation just a week earlier.
April Paskey, R.N., was involved in both the simulation and the real case. “The teamwork we had just worked on during the simulation dramatically improved our response time,” she said. “We had an excellent outcome. It was a great feeling.”
The Code Neon project has been selected for poster and oral presentations at the Alliance for Independent Academic Medical Centers conference this month in Tucson.