Communication of code status escalation for nurses and doctors in the ICU: a case study
Bibliographic record
Abstract
Interprofessional team members working in the Intensive Care Unit (ICU) care for patients requiring varying degrees of life sustaining therapy. A patient’s code status can assist healthcare professionals understand the appropriate life support measures to deliver to patients in this setting. Utilizing Stake’s approach to case study research, this study explored the communication processes that occurred between nurses and doctors in an ICU in Toronto, Canada. Participants included nurses and physicians working in the ICU. Data were collected using semi-structured interviews, observations of health care rounds and a chart review. The themes that emerged from this study include: (1) engaging in a multidisciplinary discussion, (2) finding consistent documentation, (3) revisiting the code status, and (4) telling the story. The results of this study elucidate current communication methods to guide future practices on how to effectively disseminate code status decisions amongst interprofessional ICU team members.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.034 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.019 | 0.006 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".