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Improving In-Hospital Resuscitation Using A Code Bundle

Paris Hotel and Casino  Las Vegas, Nevada. Improving In-Hospital Resuscitation Using A Code Bundle. Tim McFeely RN, NE-BC. Presenter Disclosure Information. Tim McFeely RN, NE-BC Improving In-Hospital Resuscitation Using A Code Bundle FINANCIAL DISCLOSURE: No Financial Disclosures

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Improving In-Hospital Resuscitation Using A Code Bundle

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  1. Paris Hotel and Casino  Las Vegas, Nevada Improving In-Hospital Resuscitation Using A Code Bundle Tim McFeely RN, NE-BC

  2. Presenter Disclosure Information Tim McFeely RN, NE-BC Improving In-Hospital Resuscitation Using A Code Bundle FINANCIAL DISCLOSURE: • No Financial Disclosures UNLABELED/UNAPPROVED USES DISCLOSURE: • No Disclosures

  3. Bundle Creation Background • “Good” historical results • Long standing culture • New eyes to the organization are not always welcomed

  4. WellSpan Health • Four hospital system in South Central Pennsylvania • York Hospital • 558 beds • Level 1 trauma center • Community based teaching hospital

  5. Code Bundle • Pre-Arrest inventory • Arrest process • Post-Arrest care

  6. Pre-Arrest Inventory • Equipment • Defibrillators, code carts • People • Right response team(s) to the right areas • Education • First responders • Notification methods • Backup plans

  7. Arrest Process • Review of arrests for trending issues • One person more easily identifies process gaps • Problem focused, interdisciplinary QI • Issues found and addressed in the process • Compressions stopped for intubation • Compressions stopped for line starts • Treatment on the floor after ROSC

  8. Arrest Process • Arrest observations • Get on the chest, stay on the chest • Faster, deeper reminders • Debrief process with objective data • Video

  9. Post-Arrest Care • Get to the ICU! • Therapeutic hypothermia evaluation/initiation • Cool quick and be consistent with care • aEEG monitoring

  10. Our Outcomes • Increase from 26% to 37.4% survival to d/c for in-hospital arrests in one year • TH patients increased from 34 to 84 and on pace for 120 this year • All initial rhythm TH survival to d/c increased from 28% to 50% in one year

  11. Thank You

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