Code Blue Announcement

[airborneinf82, BSN]

So just wanted to get some thoughts from other people here. The hospital I work for has just announced that they will no longer overhead page code blue's with the room number. Instead (as is currently in place) a pager (beeper) system will be used to alert people to respond.

Does anyone else work in a place that does this? I think the main reasons cited for the change are pt/families concerns with the anxiety of thinking it is their family member and also HIPPA violations. I don't really see much case for the HIPPA violation and I think doing it to appease families is the wrong reason.

Here's my biggest concern. FIrst off my floor is split on 2 wings and without an overhead page people on one wing would be clueless to what is going on with the other side, meaning less help to get there within the first 10-20 seconds. Secondly, and sort of inline with my first concern is that the studies show that if someone is VF or VT that if they can be shocked within 2 minutes as opposed to even 5 minutes, the outcome is drastically improved. I guarantee it takes longer than 2 minutes (even on our telemetry floor) to notice someone is in a lethal rhythm and to sound the code, have the paging system go off, and for people to get to the floor from other floors.

At least with the overhead page, you can get the experienced floor personel to the room quickly and can get to patient prepped with the pads and start analyzing the rhythm to get them shocked asap if need be.

I don't know. I don't think anyone likes the idea, including the docs I"ve talked to. What do you guys think?

[That Guy, BSN, RN, EMT-B]

Old hospital I worked at paged over the vocera badges that we used to communicate. Int heory it should have worked well, but the damn badges never worked so they always resorted to overhead announcements. I liked the overhead because it made it very clear to my charge nurse where I was going to be for awhile and the people that needed t be there were there fast.

[brainkandy87]

My hospital used to have the whole pager system. Didn't work, ended up just being a huge clusterfk, so we overhead page again. Considering how precious time is in a code, I don't see how any hospital could think a pager system would work. What if RT isn't carrying their pager at the time or so and so? A more sensible system is having designated individuals show up (e.g. if we have a code on another floor, the ED charge nurse and ED physician go, RT goes, etc) when a code is paged overhead.

[FLmomof5]

Another point is....what if you are in an infection control room? Are you going to touch that pager before you leave? No. So you keep on working and valuable time is lost.

[anotherone, BSN, RN]

Overhead page through out the whole hospital that states what type of code( peds vs adult- there is a number code exclusive to each ),and the unit.

[Fedide]

The hospital I worked at used the overhead page system, but it was not called a "code blue", as everyone seems to know what that means. We had a number, "code ###".

[dudette10, MSN, RN]

HIPAA violation and family anxiety? Like families don't know the room number of their own family members? Room numbers overhead without a name are PHI? What a load of hogwash...

The logistics of this confuse me. Who is paged for code #1? Who is paged for immediately subsequent code #2? How does the central paging system account for multiple codes at the same time? Does everyone and their mother show up for #1, and then confusion starts for #2? I'll go. No, you go. No, you go.

Part of the beauty of overhead pages is that everyone in the hospital is on alert. I was once in a class during orientation and there were SIX--yes 6--RRTs within a one-hour timeframe. The instructor was an ICU nurse educator, and she closed the class and went to check if assistance was needed in the various rooms.

The "let's be quiet about this" mentality is not a patient safety concern. It sounds like its a patient satisfaction concern...don't want anyone to know that there are REALLY SICK PEOPLE in this hospital!

[Double-Helix, BSN, RN]

Our hospital uses overhead pages, but only lists the unit, not the room number. Then, staff alert the code team to the appropriate room when they arrive.

[LoveSbux]

Our hospital uses overhead pages, but only lists the unit, not the room number. Then, staff alert the code team to the appropriate room when they arrive.

Yup, this exactly.

[Been there,done that, ASN, RN]

Do you know for sure, what the change is driven by?

I have noted a trend towards communicating codes via pager.Recently, I was carrying an assigned Cisco phone... that started to blow up with messages aimed toward the NSTEMI response team.

Not only did I have to take my time out of patient care to respond to this, I also had to find out how to direct these calls.

The pager system is fraught with human frailties .Give me the overhead announcement any day.

The room number is not necessary, just the unit... any responders will feel the chaos.

[Been there,done that, ASN, RN]

Your instructor is a class act!

[umcRN, BSN, RN]

we have an overhead alarm that goes off the second the code button is hit, it only alarms in the unit, about 10 seconds after that a page goes out to our phones (we all have them) with the room number. In unit the entire staff get the page, then the PICU code team gets the page. On the heart & kidney unit (i work peds btw) the codes will also go to the cardiac ICU docs phones (though since the fellows take turns between the units it typically gets to all the fellows no matter where the code). It works very well. I am not sure how the paging system is set up but there's no

in between" person from hitting the code button to getting the page, the buttons are linked directly to our phones.

I also only work in ICU so I can't say what the response time is to patients on the floor but for the cardiac kids they can usually get there fast enough to bring them to the ICU and have them on ECMO w/in 40 minutes if needed.