Abstract：
BACKGROUND: Code Blue activations in patients who are not for resuscitation (NFR) may be regarded as non-beneficial and may cause harm to patients, relatives and hospital staff.
OBJECTIVE: To estimate the prevalence of non-beneficial Code Blue calls in a metropolitan teaching hospital and identify modifiable factors that could be utilised to reduce these events.
METHODS: The study consisted of two parts: (i) a retrospective analysis of all Code Blue activations over a 12-month period using prospectively collected data. Non-beneficial activations were defined as calls made in patients with a NFR order in either the current or any previous hospital admissions and (ii) an anonymous voluntary survey of staff who were present at a Code Blue activation.
RESULTS: There were 186 Code Blue activations over the study period, with 48 (25.8%) defined as non-beneficial. Such patients had more comorbidities, previous hospitalisations and greater levels of frailty. Most non-beneficial calls occurred on general wards and more than three-quarters of patients had been reviewed by a consultant prior to the call. The survey determined that despite ward staff having a considerable degree of resuscitation experience, there were deficiencies in understanding of Code Blue criteria, the resuscitation status of patients under their care and the interpretation of goals of care.
CONCLUSIONS: Over a quarter of Code Blue calls were deemed non-beneficial. Improving the visibility of NFR status and staff understanding of patient goals of care are needed, along with timely, proactive documentation of NFR status by experienced clinicians.
OBJECTIVE: To estimate the prevalence of non-beneficial Code Blue calls in a metropolitan teaching hospital and identify modifiable factors that could be utilised to reduce these events.
METHODS: The study consisted of two parts: (i) a retrospective analysis of all Code Blue activations over a 12-month period using prospectively collected data. Non-beneficial activations were defined as calls made in patients with a NFR order in either the current or any previous hospital admissions and (ii) an anonymous voluntary survey of staff who were present at a Code Blue activation.
RESULTS: There were 186 Code Blue activations over the study period, with 48 (25.8%) defined as non-beneficial. Such patients had more comorbidities, previous hospitalisations and greater levels of frailty. Most non-beneficial calls occurred on general wards and more than three-quarters of patients had been reviewed by a consultant prior to the call. The survey determined that despite ward staff having a considerable degree of resuscitation experience, there were deficiencies in understanding of Code Blue criteria, the resuscitation status of patients under their care and the interpretation of goals of care.
CONCLUSIONS: Over a quarter of Code Blue calls were deemed non-beneficial. Improving the visibility of NFR status and staff understanding of patient goals of care are needed, along with timely, proactive documentation of NFR status by experienced clinicians.
摘要：
背景：不进行复苏（NFR）的患者的蓝色代码激活可能被认为是无益的，并可能对患者造成伤害，家属和医院工作人员。
目的：评估大城市教学医院中无益处的CodeBlue电话的患病率，并确定可用于减少这些事件的可修改因素。
方法：该研究包括两个部分：（i）使用前瞻性收集的数据对12个月内所有CodeBlue激活进行回顾性分析。非有益激活被定义为在当前或任何以前的医院入院中对具有NFR命令的患者进行的呼叫，以及（ii）对处于CodeBlue激活中的工作人员进行的匿名自愿调查。
结果：研究期间有186次蓝色代码激活，48（25.8%）被定义为非有益的。这样的病人有更多的合并症，以前的住院治疗和更严重的虚弱。大多数非有益的电话发生在普通病房，超过四分之三的患者在电话之前已经由顾问进行了审查。调查确定，尽管病房工作人员拥有相当程度的复苏经验，对蓝色代码标准的理解存在缺陷，患者在护理下的复苏状况和护理目标的解释。
结论：超过四分之一的CodeBlue呼叫被认为是无益的。需要提高NFR状态的可见性和工作人员对患者护理目标的理解，随着及时，由经验丰富的临床医生主动记录NFR状态。
目的：评估大城市教学医院中无益处的CodeBlue电话的患病率，并确定可用于减少这些事件的可修改因素。
方法：该研究包括两个部分：（i）使用前瞻性收集的数据对12个月内所有CodeBlue激活进行回顾性分析。非有益激活被定义为在当前或任何以前的医院入院中对具有NFR命令的患者进行的呼叫，以及（ii）对处于CodeBlue激活中的工作人员进行的匿名自愿调查。
结果：研究期间有186次蓝色代码激活，48（25.8%）被定义为非有益的。这样的病人有更多的合并症，以前的住院治疗和更严重的虚弱。大多数非有益的电话发生在普通病房，超过四分之三的患者在电话之前已经由顾问进行了审查。调查确定，尽管病房工作人员拥有相当程度的复苏经验，对蓝色代码标准的理解存在缺陷，患者在护理下的复苏状况和护理目标的解释。
结论：超过四分之一的CodeBlue呼叫被认为是无益的。需要提高NFR状态的可见性和工作人员对患者护理目标的理解，随着及时，由经验丰富的临床医生主动记录NFR状态。
