Nursing Role in the Code ProcessBWH Nurse - For and about the Nursing Staff of Brigham and Women's HospitalNursing Role in the Code ProcessBWH Nurse - For and about the Nursing Staff of Brigham and Women's Hospital

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Nursing Role in the Code Process

Code process continually undergoes improvement to provide the most timely and effective emergency care throughout the hospital, and nurses are an essential part of that process.

Created three years ago by the standing CPR Committee, the code team is a multidisciplinary effort based on BWH data as well as national research on successful emergency response efforts. A tower team handles inpatients and a separately organized ED team handles outpatients. According to Judith Perron, RN, MSN, “One of the critically important things the committee had to determine was how best to utilize nurses on the team,” she said.

After collecting and examining data on BWH codes and discussions from throughout the hospital, the committee structured a tower code team made up of respiratory therapists, residents in medicine, surgery and anesthesia and a 12D cardiac nurse who is dedicated to the team.

From her vantage point as 12D day nurse in charge, Suzanne Lieberman has staffed many of the code responses since the team was formed three years ago. She is also a newly appointed member of the CPR committee. “Cardiac care nurses are a good fit on the team because of their day-to-day patient experience, use of defibrillators and administering medication,” she said. She also credited the team’s cross training in enabling members to do their own roles and others on a team whose members constantly change. As of this summer, tower code team members are participating in Stratus Center emergency preparedness simulations.

Mary Lou Moore, nurse manager on 12D said, “It has been incredibly helpful to have a consistent set of nurses participating during inpatient codes. Trained in cardiopulmonary nursing, they are in a position to synthesize their experiences with one another, evaluate everything from process to equipment to performance and give valuable feedback to the committee for quality improvement.

The current tower code team coordinator – Patricia Crispi, RN, BSN, CCRN who among other roles, works with the code team to ensure detailed and accurate data is recorded for each event. This element has become increasingly important to the code effort because it enables the CPR Committee to analyze what went well and what future improvements need to be made. BWH is also a participating member of The American Heart Association’s National Registry of Cardio-Pulmonary Resuscitation (NRCPR) that reports on national code response trends based on data collected from hospitals around the US.

“Nurses are an integral part of the code teams. We are continually seeking ways to enable swift, smooth and effective responses that achieve the best outcomes,” said Jeffrey Rothschild, MD, director of the code team. “The experience and perspective of nursing team members has been essential in helping us move forward on these goals,” he said.