Does your hospital plan for code blue events?

  1. At several hospitals there is a policy to always keep an empty bed staffed in a critical care unit in case of an in- house code.

    Others staff to the minimum.
    They wait until there is a code. When at least one critical care nurse is with the patient in the unit where the code happened the others must triage, call doctors, get the room cleaned, and THEN transfer the post arrest patient into the newly cleaned room.

    Night shift in small to medium hospitals has only 1 or 2 houskeepers (enviornmentsl service). This person must clean all delivery rooms and emergency cdepartment areas between patients. This is unfair to patients, houskeepers, nurses, and doctors waiting to bring the post arrest patient to the ICU or CCU.

    How does your hospital policy address this?
  2. Poll: Does your hospital policy plan a staffed critical care bed in case of an in- house co

    • Yes, and we are able to care for our other patients safely as well.

      44.44% 4
    • Yes, but if the patient needs 1:1 care there is not enough staff

      22.22% 2
    • Yes, but although it is written we are either full or do not have a nurse for the patient.

      22.22% 2
    • No. They flately admit they do not plan for medical emergencies.

      11.11% 1
    9 Votes / Multiple Choice
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    About pickledpepperRN

    Joined: Mar '99; Posts: 13,361; Likes: 1,376


  4. by   ERNurse752
    In my hospital, there is always a "code bed" available in the ICU for an in-house code. It is assigned to someone at all times, in the event that someone needs it. It is kept clean, as no one else is in the room. As soon as the pt is stabilized, they are moved to the ICU.

    We also have a program in our hospital where the ICU charge nurse carries a code blue pager...and the floor nurses can also page him/her if they think a pt is starting to go bad. The ICU nurse can go assess the pt and initiate ICU protocols to try to turn things around. If it's possible to keep the pt out of the ICU they do, if not, that nurse can also arrange for a stat transfer to ICU. It works very well...saves a lot of time in critical situations, and keeps pts out of the ICU who really don't need to be there...which leaves open beds for our ICU pts down in the ER.
  5. by   Zee_RN
    Keeping an open bed in ICU: we do, we don't, we do, we don't...It depends on the mood of the day. *sigh* There is no official policy and it depends on who is in charge that day. But lately it's not been a problem. ICU census has been down and it's just beginning to get a wee bit concerning.

    ICU charge nurse goes to all in-patient codes in the hospital. We are still old-fashioned and codes are paged via the overhead system. We staff to the minimum in ICU. If acuity is lower (patients' status have been changed to Telemetry or, worse yet, Med-Surg but there's no place to transfer them to), we staff lower. It's getting horrific. I just had an assignment of one med-surg patient, one telemetry patient and one ICU patient with significant psychiatric problems. It was a terrible day--from an ICU standpoint.
  6. by   pebbles
    No beds are kept open, although if someone is well enough to be transferred out to a step-down unit, they'll push for that to happen sooner so that they have a bed available for emergencies.

    One nurse in the ICU is assigned to be the Code Nurse for that shift, and attends all code blues along with the doctor. That nurse either has no assigned pt in the ICU or has a very stable pt. If there is a code blue, and there are no other beds, the most stable pt gets turfed out. Hey, publicly funded means that all hospitals in the city are under the same administration, so if in dire straits, they can transfer a pt to an ICU in another hospital.

    We had a BAD winter this past year with every ICU bed in the entire city being full... someone on the ward codes, they have to send us someone in exchange. Usually someone who is not quite stable enough to be out of the ICU yet. That person will then crash a day or so later, and the cycle continues. We had quite a few pt's bouncing back and forth between the ICU and the wards because the system couldbn't handle the volume of sick pt's. It was a bad winter for staff burnout, as well as I'm sure pt's died as a partial result of this.
  7. by   fergus51
    We don't keep the bed empty. If there is an in house code blue that patient gets an ICU bed and the least sick pt up there gets transfered to the stepdown or med-surg.
  8. by   pickledpepperRN
    Once the patient who had just been moved out of the ICU to make room for the post arrest coded!
    We had this patient in the hallway on a life-pak with a ventilator, Dopamine, etc. for several hours.
    The same nurse had both patients plus another "stable" patient.
  9. by   New CCU RN
    We keep a bed open and staffed in the CCU generally. If we needed to put the bed in another ICU we do, however the code beeper stays in CCU. The bed is always ready and waiting!
  10. by   pickledpepperRN
    Originally posted by New CCU RN
    We keep a bed open and staffed in the CCU generally. If we needed to put the bed in another ICU we do, however the code beeper stays in CCU. The bed is always ready and waiting!
    Good! Does anyong think it should be any other way?
  11. by   whipping girl in 07
    We usually have a "code" bed available, and we usually start the shift with admitability of two beds, unless we are full. When we are full, a code is supposed to go to ER. But, if we are full at a shift change and another unit is over a nurse, they will pull that nurse to us (whether they know anything about ICU or not). So when we get a pulled nurse, we give them the most stable assignment and then the other ICU nurses with the most stable assignments also keep an eye on the pull nurse's patients. We do have some nurses that get pulled to us with ICU experience, but we can no longer pull a nurse to stepdown and then pull a nurse from stepdown to us. Very frustrating.