Code blue: Getting nurses to patients’ bedsides faster than ever before

Nurse attending to IV bag

If you or your loved one has ever been in the hospital, you know how much trust you put in nurses and doctors. You want reassured that in any emergency, or ‘code blue’ when the heart stops beating, your nursing staff will rush to your bedside as quickly as possible. In those situations, time is precious and time can save lives. New research by The Ohio State University School of Health and Rehabilitation Sciences and The Ohio State University Wexner Medical Center is helping nurses get to patients in cardiac arrest faster than ever before.

During their shift, nurses take care of several patients and respond to multiple alarms going off on the unit and through personal paging devices. The constant beeping can wear on nurses and lead to alarm fatigue. By assigning distinct sounds and tones to emergencies like a code blue, nursing teams are able to recognize the severity of the alarm and attend to their patients quickly and efficiently.

“We devised a way to save lives by getting nurses to the bedside of patients in cardiac arrest faster while eliminating the number of alarms nurses get,” said the study’s lead author Emily Patterson, principal investigator and professor in the School of Health and Rehabilitation Sciences. “The reductions ranged from 15% to 59% faster response time during the study and they continued to improve after the study ended.”

Patterson and her research team looked at the benefits of this new alarm system to reduce nurse response time for emergencies, and also studied overall alarm burden. They focused on the secondary alarm notification system (SANS), which sends alarms by mobile phone so nurses can receive notifications no matter where they are on the hospital unit. It’s a common strategy hospitals use to reduce alarm response time, and it’s used in addition to alerts at the bedside and nursing station. SANS can be triggered by hospital staff, patients or machines, and the alerts usually sound the same.

In the study published in the journal Human Factors in July 2021, researchers looked at ways to help nurses using SANS distinguish between an emergency and all other alarms. Also, Patterson and her team wanted to find ways to reduce redundant alarms or those with high false alarm rates.

“We documented nurse alarm and response time at three hospitals for 14 months prior to implementing the alarm changes, and then we followed the same nursing units for another 25 months after the changes,” Patterson said. “There was a statistically significant reduction in duration time for the code blue alarm at all three hospitals and the alarm burden fell by 20-38%. We believe by reducing the overall number of alarms, we allowed nurses to better identify code blue alarms.”

Future research is needed and will be led by the study’s co-investigator Mike Rayo, an assistant professor at The Ohio State University College of Engineering. Rayo’s research will be grant-funded and will focus on how auditory alarms can be integrated into visual displays to better inform nurses that a patient emergency is happening. Rayo also will look at how these findings can influence alarm and decision-support design in non-clinical hospital settings such as Central Sterile Supply, a facility responsible for reprocessing and sterilizing surgical equipment and distributing all sterile supplies.

Other Ohio State researchers on this study included, Christopher J. Hansen, Todd Yamokoski, Mahmoud Abdel-Rasoul, Theodore T. Allen, Jacob J. Socha and Susan Moffatt-Bruce, MD, PhD.

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