Media Annotation: Critical Appraisal of Christiana Care Health System’s Code Blue Simulation Program

Running head: MEDIA ANNOTATION
MEDIA ANNOTATION
Name of the Student:
Name of the University:
Author Note:

1MEDIA ANNOTATION
Introduction:
Simulation forms an integral aspect of learning and developing practical experience in the
field of nursing. Before Graduate Nurses enter into practice, they acquire clinical experience
based on simulation and learning. As stated by Matthew, Norris and Krockenberger (2017),
simulated learning can be compared to that of mock learning which enables nursing
professionals to think critically in a complex clinical scenario and accordingly undertake crucial
decisions so as to promote wellness of the patients. According to Crowley (2013), one particular
advantage of simulated learning in the field of nursing can be explained as providing an exposure
to the Graduating Nurses about how a tense practical clinical scenario might look like and
accordingly assist them with handling such situations with precision. This paper would critically
appraise one such simulation video titled ‘Christiana Care Health System’s Code Blue
Simulation Program’. The content of the video would be discussed and appraised in relation to
the scholarly literatures and the ARC guideline of resuscitation (Resus.org.au, 2019) so as to
evaluate that whether or not the simulation performed was appropriate and aligned to the
standard CPR technique.
Analyzing quality of performance using the ARC guidelines:
The video starts with a nurse walking inside the Ward, who asks the dummy patient (Mr.
Maddie) about his wellness. She does not receive any response from the patient and calls for help
when all the other care professionals walk in. She mentions that the patient had been fine 5
minutes ago and at present is not responding. She orders the team to start the CPR technique. At
0.28s, she mentioned that she is not getting any pulse and then order the team to start with the
CPR technique. The first issue in the video can be identified at this stage where the team starts

2MEDIA ANNOTATION
preparing for the CPR with Nancy attaching the pads and directly starting with the CPR
technique. Clearly, there was no instance of recording or documenting the patient’s pulse. The
situation mimics a scenario where the patient has encountered a cardiac arrest. Clearly, in such a
condition the care professionals are expected to call for the emergency code and initiate CPR as
the CPR Guidelines published by the Australian Resuscitation Council (Birkenes et al., 2014).
Further, the ANZCOR guidelines also recommend initiation of the CPR technique on a patient
that experiences cardiac arrest. In addition to this the ANZCOR guidelines recommends that
CPR should only be started when the patient is not breathing normally and is unresponsive
(Resus.org.au, 2019). In addition to this, in such cases the Bystander CPR technique is highly
recommended (Kammeyer, Pargett & Rundell, 2014). Further, the guidelines also suggest that
the exact compression to ventilation ratio must be 30:2 for all age groups. Also, the
recommended chest compression that is recommended to be provided is equivalent to 100 to 120
per minute (Shin et al., 2014). Also, interruptions while performing chest compressions are
recommended to be minimal. Also, before performing CPR it is mandatory to conduct the DRS
ABCD assessment. The DRS ABCD assessment can be elaborated as Dangers, Responsiveness,
Send for help, Airway, Breathing, CPR and Defibrillation. Clearly, the video lacked this
assessment (Betterhealth.vic.gov.au, 2019). Also, the guidelines suggest that while performing
CPR, there should be minimal interruptions while the process of chest compression is going on.
The guidelines also suggest that there could be risks in relation to infection while performing
activities like intravenous cannulation or use of barrier device during the process of rescue
breathing. In such situations, it is highly recommended that the patient must be checked for
resuscitation related injuries which was again not found to be addressed in the video.
Quality assessment of the Video:

3MEDIA ANNOTATION
Therefore, on the basis of the above discussion, a clear discussion about the ANZCOR
resuscitation guideline has been presented. Upon comparing the quality of the video with the
guidelines, it can be mentioned that the video was of poor quality as a number of guidelines were
not followed (Monsieurs et al., 2015). However, upon analyzing the quality of clinical leadership
skills of the nurse, it can be mentioned that the video represented excellent leadership qualities
during an emergency situation. On the other hand, it cannot be denied that the video comprised
of a number of technical errors. According to Price, Smith and Challiner (2016), clinical
leadership within an emergency unit critically takes charge of the situation and based upon the
intricate understanding dispenses commands to the team of care professionals. In this case, it was
observed that the nurse leader critically delivered instructions in a clear and coherent manner to
the care professionals in relation to the CPR technique. This can be stated right from the start
when she instructs Nancy to put the pads on the patient before commencing CPR. Further, she
instructs Nancy to continue pumping for 2 minutes and inform once the 2 minutes were over.
She also clearly instructs about the dose of epinephrine IV push that was administered to the
patient. She also clearly instructs the defibrillator to be set at 200 joules and at 1min 03 seconds,
it is seen that she sets the defibrillator at 200 Joules herself which indicates that she makes sure
that the defibrillator is set appropriately (Seifert et al., 2016). Also, at each instance she
communicates clearly with team of the healthcare professionals and assists them appropriately to
perform the CPR technique correctly. She also discusses the further course of the treatment with
the care professionals present within the room, which suggests an instance of informed decision
making. Also, she clearly makes use of the medical codes and terms in order to communicate
with the team. This can be considered as an added positive aspect of the video as it presents a
clear overview about the CPR technique within an emergency care unit for the nursing students