Date Available

4-19-2025

Year of Publication

2025

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Candice Falls

Committee Member

Dr. Jenna Haupert

Faculty

Dr. Holly Chitwood

Abstract

Background: Post-code debriefs are shown to improve teamwork and communication, increase performance, and reduce burnout. According to the University of Kentucky HealthCare (UKHC) policy, teams are to perform a post-code debrief immediately after an in-hospital cardiac arrest (IHCA). However, the current policy does not provide guidance on what to include during a debrief session. At UK post-code debrief sessions are documented as occurring 60-72% of the time; however, personal observation and discussions with other bedside and rapid response nurses suggest that post-code debriefs are underperformed when compared to the documentation. Purpose: This study aimed to explore barriers to post-code debriefs and implementation of a pilot post-code debrief tool initiated by the chaplains and unit lead nurse within the University of Kentucky Medicine Intensive Care Unit (MICU). Methods: A pre- and post-intervention quality improvement study at the UKHC MICU involving the bedside nurses and chaplains. The study consisted of a pre-education and intervention survey, an education intervention, the implementation of a pilot post-code debrief tool, and a post-education/implementation survey of the pilot debrief tool. The educational intervention will involve a short PowerPoint presentation on the importance of post-code debriefing and how to use the pilot post-code debrief tool. Results: The study included 27 participants (25 nurses, 2 chaplains) who completed both pre- and post-surveys. Before the debrief tool, 82% participated in debriefs 0-22% of the time; post-tool, 33% of participants stated an increase in debrief participation to (51-74%), and 26% debriefed 74-100% of the time, with a significant improvement (p < 0.001). Time remained the main barrier, with additional factors like patient care and family presence noted post-tool. Participants found the "What went well/what could be improved" section most beneficial. Most (82.7%) were satisfied with the tool, and 95.7% wanted more frequent debriefs. Documentation often overestimated actual debriefing rates, highlighting the need for clearer leadership and improved crowd control during code events. Discussion: This study evaluated a pilot post-code debrief tool in a Level 1 MICU, finding that debriefs occur less frequently than documented but were significantly increased with the tool. While time efficiency wasn’t addressed, the study highlighted the importance of a designated leader and chaplain involvement. Participants found the "What Went Well" and "What Could Be Improved" sections most beneficial, emphasizing the value of structured debriefs in improving code blue outcomes. Conclusion: This study highlights the underutilization of post-code debriefs in critical care units, with time as the main barrier. It emphasizes the importance of a designated leader and shows that a structured debrief tool significantly improved debrief frequency.

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