Features of the triggering of the yellow code and factors associated with the occurrence of adverse events.
Pollyana Karine Lopes Dos Santos, Gabriella Novelli Oliveira, Karina Sichieri and 2 others
PMID 36946812WHAT IT FOUND
Nurses triggered the yellow code most often for low oxygen or low blood pressure.
Longer rapid response team care was associated with ICU admission or cardiac arrest, though the study was small and retrospective.
Key findings
01Decreased peripheral oxygen saturation and hypotension were the most frequent signs triggering the yellow code.
02Longer duration of rapid response team care was the only factor associated with adverse events like unplanned ICU admission or cardiac arrest.
03The average time for the rapid response team to arrive after activation was 12.9 minutes, exceeding the institutional recommendation of 5 minutes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in a single hospital with a small sample size of 91 patients, limiting the generalizability of the results. The association between longer RRT care time and adverse events is correlational; it is likely that sicker patients required longer care, rather than the long care itself causing the bad outcome. The study did not measure 30-day mortality, only events immediately following RRT care.
The easy way to misread this
Do not conclude that keeping the Rapid Response Team in the room longer causes patients to deteriorate. The finding that longer care time is associated with adverse events likely reflects that patients who were already more critically ill required more time and interventions from the team.