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key takeaways

  • Compared to paper-based documentation methods, studies have shown that electronic Code Blue documentation reduces errors and omissions and improves overall data capture.
  • Hospitals looking to invest in an electronic documentation tool should prioritize ease of use, accurate timekeeping, and real-time code guidance to ensure maximum impact.

Across hospitals today, the transition from paper to digital documentation is well underway, but far from complete.

Case in point: When a patient goes into cardiac arrest, the critical, life-saving actions taken by the Code Blue team are still captured on paper at most hospitals in the United States. This is true even though studies have shown that electronic Code Blue documentation tools reduce errors and omissions and improve overall data capture.1,2

But it’s not as simple as switching to any electronic format and hoping to gain some of the benefits mentioned above. Choosing the right documentation tool will affect everything from ease of adoption to quality of patient care — and it can be hard to know which features to prioritize.

What that in mind, we rounded up the top 3 things to look for in an electronic Code Blue documentation tool to ensure your hospital’s switch to digital documentation has maximum impact.

1. Ease of use

Why it matters:


  • Codes move quickly, and scribes need to be able to keep up. If clinicians are losing valuable time fumbling through a clunky documentation tool or searching for interventions to select, they risk incomplete or inaccurate data capture — exactly the problems electronic documentation is supposed to avoid.
  • If it’s difficult to use, it won’t get used at all. Instead, clinicians are likely to revert to paper-based documentation methods during the code and enter the information in the electronic tool later. But this wastes valuable staff time and introduces error.

What to look for:


  • Intuitive, easy-to-use interface.
  • Ability to fully document interventions with one action.
  • Easy access to the list of medications and interventions used most during a code, without having to struggle with cumbersome and time-consuming navigation functions.
  • Ability to customize the contents of the medication/intervention list and how they appear.

The Nuvara® edge:


CoDirector® Resuscitation Software gives hospitals the ability to customize and pin a list of common interventions for each rhythm. This minimizes the amount of noise on the screen and brings relevant information into focus — allowing scribes to document quickly, accurately, and efficiently.

2. Accurate timekeeping

Why it matters:


  • Code Blue execution is extremely time-sensitive, and timing discrepancies ranging from seconds to minutes can quickly add up.
  • Event timing is one of the least standardized aspects of Code Blue events. Responders might turn to their phone, watch, or a defibrillator to timestamp key interventions during the same code event.3,4
  • When timing records are off, it’s hard to get a true picture of the effectiveness of any individual code or compare performance across events.

What to look for:


  • Electronic timestamping of key events: when the code starts and stops, when medications are administered, etc. Choose a Code Blue documentation tool that tracks this information automatically, and you’ll save your hospital the headache of trying to manually enforce timepiece standardization across staff.

The Nuvara edge:

Here’s what sets CoDirector apart:

  • Automatically inserts timestamps in the event log when an intervention is documented.
  • Includes a timer for event duration as well as the current time.
  • Offers dynamic timers for recurring actions during the code (e.g., compressions, pulse and rhythm checks, epinephrine, atropine, and vitals).

3. Real-time Code Blue guidance

Why it matters:


  • Effective Code Blue response is driven by best practices and Advanced Cardiac Life Support (ACLS)/Pediatric Advanced Life Support (PALS) algorithms, but even the most seasoned clinicians can get off track during a stressful emergency event.
  • The best electronic documentation tools offer more than recordkeeping alone. They also help guide clinicians during the code and increase adherence to best practices.

What to look for:


  • Alignment with ACLS/PALS algorithms.
  • Built-in guardrails to help responders stay focused during a high-stakes emergency.
  • A tool that empowers scribes to guide and direct the team’s response according to best practices.

The Nuvara edge:


  • Dynamic timers are augmented with visual cues to pace recurring actions during the code based on ACLS and PALS protocols.
  • Allows scribes to easily edit the event log for previously documented items in real-time.
  • Produces an immediate debriefing report that highlights performance achievements and deviations compared to American Heart Association recommendations and ACLS/PALS algorithms.


See for yourself

Nuvara’s CoDirector Resuscitation software can transform emergency response at your hospital.


  1. Grigg E, Palmer A, Grigg J, et al. (2013, July 29). Randomised trial comparing the recording ability of a novel, electronic documentation system with the AHA paper cardiac arrest record. Emergency Medicine Journal, 1–7.
  2. Peace JM, Yuen TC, Borak MH, et al (2014, Feb.) Tablet-based cardiac arrest documentation: a pilot study. Resuscitation, 85(2): 266-269.
  3. Allan N, Bell D, & Pittard A. (2011). Resuscitation of the written word: Meeting the standard for cardiac arrest documentation. Clinical Medicine, 11(4), 348–52.
  4. Ferguson EA, Bayer CR, Fronzeo S, et al. (2005, March 1). Time out! Is timepiece variability a factor in critical care? American Journal of Critical Care, 14(2), 113–120.
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