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Perceptions of Teamwork Among Code Team Members

Mahramus, Tara MSN, RN, CNS, CCNS, CCRN; Frewin, Sarah MSN, CNS, CCNS, PCCN, CHFN; Penoyer, Daleen Aragon PhD, RN, CCRP, FCCM; Sole, Mary Lou PhD, RN, CCNS, FAAN, FCCM

doi: 10.1097/NUR.0b013e3182a8729d
Feature Article

Background: Cardiopulmonary arrest (CPA) teams, known as code teams, provide coordinated and evidenced-based interventions by various disciplines during a CPA. Teamwork behaviors are essential during CPA resuscitation and may have an impact on patient outcomes.

Objectives: The purpose of this study was to explore the perceptions of teamwork during CPA events among code team members and to determine if differences in perception existed between disciplines within the code team.

Methods: A prospective, descriptive, comparative design using the Code Teamwork Perception Tool online survey was used to assess the perception of teamwork during CPA events by medical residents, critical care nurses, and respiratory therapists.

Results: Sixty-six code team members completed the Code Teamwork Perception Tool. Mean teamwork scores were 2.63 on a 5-point scale (0–4). No significant differences were found in mean scores among disciplines. Significant differences among scores were found on 7 items related to code leadership, roles and responsibilities between disciplines, and in those who had participated on a code team for less than 2 years and certified in Advanced Cardiac Life Support for less than 4 years.

Conclusions: Teamwork perception among members of the code team was average. Teamwork training for resuscitation with all disciplines on the code team may promote more effective teamwork during actual CPA events. Clinical nurse specialists can aid in resuscitation efforts by actively participating on committees, identifying opportunities for improvement, being content experts, leading the development of team training programs, and conducting research in areas lacking evidence.

Author Affiliations: Clinical Nurse Specialist, Cardiology and Medical Critical Care (Ms Mahramus), and Clinical Nurse Specialist (Ms Frewin), Cardiology, Orlando Regional Medical Center, Orlando Health, Florida; Director, Center for Nursing Research, Orlando Health, Florida (Dr Penoyer); Professor, College of Nursing, University of Central Florida, Orlando Health, Florida, and Distinguished Professor and Nurse Scientist, Orlando Health, Florida (Dr Sole).

The authors report no conflicts of interest.

Correspondence: Tara Mahramus, MSN, RN, CNS, CCNS, CCRN, 1414 Kuhl Ave, MP 107, Orlando, FL 32806 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins