Code White: Process and Protocols
Audio File
- Discuss a plan to organize and make accessible needed equipment, supplies and medications to treat a maternal hemorrhage.
- Verbalize a protocol to organize and direct response to maternal hemorrhage for all staff, providers, and rapid response team.
- Discuss the use of drills to practice use of ‘Code White’ protocol, cart, medications, and coordination of efforts in treating maternal hemorrhage with videotaping and debriefing to set staff learnings.
Improved safety in care of patient with maternal hemorrhage.
Proposed change:
Development of a system whereby staff could quickly access maternal hemorrhage medications, in a post PYXIS world; quickly and safely as well as the other supplies, and equipment needed in the care of a hemorrhaging patient.
Implementation, outcomes and evaluation:
We wanted a system whereby staff could quickly access maternal hemorrhage medications - in a post PYXIS world; quickly and safely. Through use of drills, with pharmacy present to see first hand challenges staff were facing to accessing needed medications, we have developed a workable system.
We have purchased a ‘cart’, that has a twist-tie closure similar to our adult code carts. This cart has Oxytocin, and Misoprostal readily available, with methergine, and hemabate still available as override meds, in the PYXIS, under refrigeration. The cart is stocked with all the equipment and supplies needed to respond to a hemorrhage on the floor, with the additional equipment needed for a D&C or surgical intervention available in the floor OR rooms. We educated and drilled staff on the new system. With these changes, for relatively little money (the cost of the carts was approximately$ 700 a piece), we have been able to reduce our response time to have all needed drugs and equipment/supplies in the patient's room from 30 minutes to 5 to 10 minutes, as documented in videotaped drills. We have thereby greatly increasing the safety for our patients, as well as provider and staff satisfaction with the process.
Implications for nursing practice:
We have developed an affordable, efficient response to post partum hemorrhage that would be workable anywhere.
Keywords: 3-6 key terms that can be used to index your abstract
patient safety, maternal hemorrhage, protocals, drills
