Doctor of Nursing Practice Program

Amanda Paulsen, DNP, AG-ACNP-BC, CCRN

Amanda Paulsen
  • Committee Chair Name & Credentials:
    Susanna Rudy, DNP, MSN, MFS, AG-ACNP, FNP-BC, ENP, CCRN


DNP Project Abstract

Assessment of Nursing Self-Confidence in Cardiac Arrest Documentation

Over 200,000 in-hospital cardiac arrests occur annually in the United States. Nurses responsible for documenting cardiac arrest events lack confidence in their ability to document in the “Code Narrator.” This quality improvement project aims to understand nurses’ self-confidence in cardiac arrest documentation and increase their self-confidence in cardiac arrest documentation.

A pre-intervention survey explored nurses' reported self-confidence and practices with the “Code Narrator.” In the implementation phase, educational materials for documenting in the “Code Narrator” were made available to nursing staff, then a post-intervention survey was conducted. Pre- and post-intervention surveys were analyzed to determine if educational materials increased nursing self-confidence using the “Code Narrator.”

The results from this study indicated an improvement in nurses’ self-confidence after the educational materials intervention, but a larger study of longer duration is necessary to determine clinical significance. Of the 20 nurses surveyed in the pre-intervention phase, 70% reported the “Code Narrator” was confusing and not easy to use; 90% said they would not document in the “Code Narrator,” and 85% stated they would use paper/pen over the “Code Narrator.” The results for improvement could not be fully analyzed due to limitations in study timing, and no cardiac arrest events occurred during the study period.

Implications for Practice
Direct care nurses lack confidence in accurately documenting in the “Code Narrator.” Continuing education improves self-confidence and perception of their ability. Literature supports developing high-fidelity, simulation-based learning activities. We recommend piloted use of a tablet-based code documentation tool for one-click documentation of all significant interventions.