A Quality Improvement Initiative to Reduce “Out-of-ICU” Cardiopulmonary Arrests in a Tertiary Care Hospital in India: A 2-Year Learning Experience

Abstract

Although MET intervention was successful in significantly reducing "out-of-ICU" Code Blues, focused training of nurses is required for continued quality improvement.

Evaluation of healthcare professionals' knowledge on Code Blue: A multi-centre survey study

“…Every minute in cardiac arrest is valuable. It is found more successful to start CPR in 1.5-2 minutes than in more than 5 minutes [6]. When the maximum time for the CB team to arrive at the scene was asked, most of the participants answered this question correctly but not all of them.…”

The associations between rapid response systems and their components with patient outcomes: A scoping review

“…1 for additional details of the screening process. Most studies reviewed fit within two categories: they examined the effects of rapid response implementation on patient outcomes ( Roasio et al., 2022 ; Aitken et al., 2015 ; Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ; Chen et al., 2015 ; Davis et al., 2015 ; Davis et al., 2015 ; Jung et al., 2016 ; Kawaguchi et al., 2015 ; Kim et al., 2017 ; Ludikhuize et al., 2015 ; Menon et al., 2018 ; Noyes et al., 2015 ; Pirret et al., 2015 ; Gong et al., 2020 ; Mankidy et al., 2020 ; Oh et al., 2018 ; Viana et al., 2021 ; Yang et al., 2020 ), or they described rapid response systems and their associations with patient characteristics and outcomes ( Jung et al., 2022 ; Winterbottom and Webre, 2021 ; Avis et al., 2016 ; Bunch et al., 2019 ; Chan et al., 2016 ; Churpek et al., 2017 ; Jones et al., 2017 ; Kollef et al., 2017 ; Le Guen et al., 2015 ; Psirides et al., 2016 ; Silva et al., 2016 ; Smith et al., 2015 ; Stelfox et al., 2015 ; Sulistio et al., 2015 ). Generally, rapid response system implementation studies included scenarios in which the system implemented was the first iteration of its kind ( Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ), was replacing an existing system ( Aitken et al., 2015 ), or added another tier of clinical experience or surveillance to an existing system ( Davis et al., 2015 ; Kawaguchi et al., 2015 ; Pirret et al., 2015 ).…”

“…Broad patterns of what rapid response system components were reported on in included studies were also assessed. A majority of studies (27 of 34) identified what rapid response system triggers were used ( Roasio et al., 2022 ; Aitken et al., 2015 ; Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ; Chen et al., 2015 ; Davis et al., 2015 ; Jung et al., 2016 ; Kawaguchi et al., 2015 ; Kim et al., 2017 ; Ludikhuize et al., 2015 ; Jung et al., 2022 ; Menon et al., 2018 ; Noyes et al., 2015 ; Pirret et al., 2015 ; Gong et al., 2020 ; Oh et al., 2018 ; Viana et al., 2021 ; Yang et al., 2020 ; Bunch et al., 2019 ; Churpek et al., 2017 ; Kollef et al., 2017 ; Le Guen et al., 2015 ; Psirides et al., 2016 ; Silva et al., 2016 ; Smith et al., 2015 ; Stelfox et al., 2015 ; Sulistio et al., 2015 ); additionally, a majority of studies (28 of 34) also included at least some details related to member composition of their medical emergency teams ( Roasio et al., 2022 ; Aitken et al., 2015 ; Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ; Davis et al., 2015 ; Davis et al., 2015 ; Jung et al., 2016 ; Kawaguchi et al., 2015 ; Kim et al., 2017 ; Ludikhuize et al., 2015 ; Jung et al., 2022 ; Menon et al., 2018 ; Noyes et al., 2015 ; Pirret et al., 2015 ; Gong et al., 2020 ; Mankidy et al., 2020 ; Oh et al., 2018 ; Viana et al., 2021 ; Yang et al., 2020 ; Winterbottom and Webre, 2021 ; Avis et al., 2016 ; Bunch...…”

“…Some studies also cited additional triggers such as critical labs values and decreased urinary output ( Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ; Kim et al., 2017 ; Noyes et al., 2015 ; Oh et al., 2018 ; Viana et al., 2021 ; Yang et al., 2020 ; Bunch et al., 2019 ; Psirides et al., 2016 ). A few studies cited the use of early warning scores as medical emergency team event triggers ( Ludikhuize et al., 2015 ; Jung et al., 2022 ; Menon et al., 2018 ; Pirret et al., 2015 ; Kollef et al., 2017 ; Psirides et al., 2016 ).…”

“…Of the 34 studies reviewed, 27 described criteria that comprised triggers used to activate medical emergency team events. Of these studies, 11 described institutional triggers with no further analyses ( Roasio et al., 2022 ; Davis et al., 2015 ; Kawaguchi et al., 2015 ; Ludikhuize et al., 2015 ; Jung et al., 2022 ; Noyes et al., 2015 ; Gong et al., 2020 ; Oh et al., 2018 ; Yang et al., 2020 ; Kollef et al., 2017 ; Sulistio et al., 2015 ), and 9 studies reported frequencies of triggers used to activate medical emergency teams with no further analyses ( Aitken et al., 2015 ; Al-Rajhi et al., 2016 ; Blotsky et al., 2016 ; Jung et al., 2016 ; Menon et al., 2018 ; Pirret et al., 2015 ; Psirides et al., 2016 ; Silva et al., 2016 ; Stelfox et al., 2015 ). We noted variability across studies in how triggers were described and reported.…”