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Recommended Citation
Caldwell J, Lis T. Crack the Code: Boosting Nurse Confidence in Medical Code Documentation. Professional Development podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Professional Development podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background
Medical codes events are high-stress situations. Audits of real time electronic documentation of code events revealed low compliance and missing end tidal CO2 documentation. Practice gap identified with a root cause of lack of exposure and training. For novice nurses, this is compounded with feelings of incompetence and fear, leading to incomplete documentation. Accurate documentation of assessments and interventions during code events is imperative to facilitate positive patient outcomes, quality improvement, and provide accurate data for debrief. Supplemental education increases confidence and promotes success when the nurse experiences a high-risk, low-frequency event.
Purpose
To utilize rapid-fire simulation to improve nurse confidence in medical code documentation while positively impacting quality measures.
Method
An interprofessional team of key stakeholders reviewed literature and created two standardized, mock medical code simulation videos. Training was presented to novice critical care nurses during orientation, fostering practice in real-time with subject matter expert (SME) support in a safe, simulated environment. SMEs provided feedback in real time, answered questions, and promoted repetition of skill.
Results
Learners reported increased confidence in all areas of the electronic code narrator. Overall confidence of novice nurses improved from 1.83 to 3.91 out of 5.0. In addition, novice nurse confidence exceeded experienced nurses (2.67) who did not participate in simulation. End tidal CO2 documentation increased from 33% to 100% in post intervention audits. Code narrator practice sessions in a safe space positively impacts nurse confidence which in turn impacts accurate documentation in medical emergencies.
Conclusions
Supplemental education increases confidence and promotes success when the nurse experiences a high-risk, low-frequency event. Simulated training fosters learning, creates muscle memory, and increases confidence. Developed content is easily translatable and is currently being disseminated to non-critical care units. Videos can be shared throughout the organization for further dissemination. The program’s success has resulted in the expansion across a multistate health system.
Document Type
Oral/Podium Presentation
Publication Date
11-13-2024
Crack the Code: Boosting Nurse Confidence in Medical Code Documentation
Background
Medical codes events are high-stress situations. Audits of real time electronic documentation of code events revealed low compliance and missing end tidal CO2 documentation. Practice gap identified with a root cause of lack of exposure and training. For novice nurses, this is compounded with feelings of incompetence and fear, leading to incomplete documentation. Accurate documentation of assessments and interventions during code events is imperative to facilitate positive patient outcomes, quality improvement, and provide accurate data for debrief. Supplemental education increases confidence and promotes success when the nurse experiences a high-risk, low-frequency event.
Purpose
To utilize rapid-fire simulation to improve nurse confidence in medical code documentation while positively impacting quality measures.
Method
An interprofessional team of key stakeholders reviewed literature and created two standardized, mock medical code simulation videos. Training was presented to novice critical care nurses during orientation, fostering practice in real-time with subject matter expert (SME) support in a safe, simulated environment. SMEs provided feedback in real time, answered questions, and promoted repetition of skill.
Results
Learners reported increased confidence in all areas of the electronic code narrator. Overall confidence of novice nurses improved from 1.83 to 3.91 out of 5.0. In addition, novice nurse confidence exceeded experienced nurses (2.67) who did not participate in simulation. End tidal CO2 documentation increased from 33% to 100% in post intervention audits. Code narrator practice sessions in a safe space positively impacts nurse confidence which in turn impacts accurate documentation in medical emergencies.
Conclusions
Supplemental education increases confidence and promotes success when the nurse experiences a high-risk, low-frequency event. Simulated training fosters learning, creates muscle memory, and increases confidence. Developed content is easily translatable and is currently being disseminated to non-critical care units. Videos can be shared throughout the organization for further dissemination. The program’s success has resulted in the expansion across a multistate health system.