The Relationship between Nurses' Knowledge about Emergencies and Code Blue Activation Decisions

Main Article Content

Hikmah Lia Basuni
Yayan Gusman
Maruli Taufandas
Apriani Susmita Sari
Corresponding Author:
Hikmah Lia Basuni |


Introduction: Code Blue is a hospital system created to overcome the high death rate due to respiratory arrest and cardiac arrest in hospitals. It involves all hospital components, including medical personnel, communication systems, transportation and facilities, and infrastructure. The initial principle of handling cardiac arrest is how nurses can recognize early signs of emergency so that the decision to activate code blue can be made. Knowledge about emergencies is a basic component that nurses must have in making blue activation code decisions. However, in its application, caring for cardiac arrest sufferers carried out by nurses is often still not appropriate.

Objective: This study aims to determine the relationship between nurses' knowledge of emergencies and the decision to activate code blue.

Methods: This research is a quantitative research with an analytical survey method using cross-sectional research. In this study, the non-parametric Spearman rank correlation test was carried out at the. Sampling used total sampling technique and obtained 70 respondents.

Results: There is a relationship between nurses' knowledge about emergencies and the decision to activate code blue at with a significant value of p= 0,000 (p < α 0.05), r = 0.601.

Conclusion: There is a relationship between nurses' knowledge about emergencies and the decision to activate code blue. Training resuscitation skills and increasing nurses' knowledge through regular training, workshops, or code blue simulations are recommended, especially for patient care units that rarely activate code blue.

Article Details

How to Cite
H. L. Basuni, Y. Gusman, M. Taufandas, and Apriani Susmita Sari, “The Relationship between Nurses’ Knowledge about Emergencies and Code Blue Activation Decisions”, Babali Nurs. Res., vol. 5, no. 1, pp. 67-75, Jan. 2024.
Original Research


[1] A. Rahmawati, E. Emaliyawati, and C. E. Kosasih, “Identifikasi Pelaksanaan Code Blue : Literature Review,” J. Keperawatan Sriwij., vol. 6, pp. 7–12, 2019.
[2] A. Sagun et al., “Evaluation of healthcare professionals’ knowledge on Code Blue: A multi-centre survey study,” J. Resusc. Balc., vol. 7, no. 17, pp. 274–278, 2021, doi: 10.5937/jrb7-31187.
[3] R. M. Merchant et al., “Hospital variation in survival after in-hospital cardiac arrest.,” J. Am. Heart Assoc., vol. 3, no. 1, pp. 1–8, 2014, doi: 10.1161/JAHA.113.000400.
[4] D. O. Alao et al., “The epidemiology and outcomes of adult in-hospital cardiac arrest in a high-income developing country,” Resusc. Plus, vol. 10, no. October 2021, p. 100220, 2022, doi: 10.1016/j.resplu.2022.100220.
[5] C. W. Sung et al., “In-Hospital Cardiac Arrest in United States Emergency Departments, 2010–2018,” Front. Cardiovasc. Med., vol. 9, no. April, pp. 1–8, 2022, doi: 10.3389/fcvm.2022.874461.
[6] J. Penketh and J. P. Nolan, “In-hospital cardiac arrest: the state of the art,” Crit. Care, vol. 26, no. 1, pp. 1–8, 2022, doi: 10.1186/s13054-022-04247-y.
[7] A. Z. Victoria, F. R. Ryandini, and A. Wati, Fransiska, “Gambaran Pengetahuan dan Penanganan Perawat Sebagai First Responder pada Kejadian In Hospital Cardiac Arrest (IHCA),” J. Nurs. Updat., vol. 13, no. 4, pp. 92–102, 2022.
[8] L. Munawaroh and W. Barlianto, “Relationship between Nurse Knowledge and Decision Making of Code Blue Activation in Rsud Bangil Pasuruan, Indonesia,” Int. J. Nurs. Educ., vol. 12, no. 4, pp. 86–90, 2020, doi: 10.37506/ijone.v12i4.11222.
[9] J. E. Rubin and S. E. Crowe, “Annals of internal medicine®,” Ann. Intern. Med., vol. 172, no. 1, pp. ITC1–ITC14, 2020, doi: 10.7326/AWED202001070.
[10] Darsini, Fahrurrozi, and E. A. Cahyono, “Pengetahuan ; Artikel Review,” J. Keperawatan, vol. 12, no. 1, p. 97, 2019.
[11] Soekidjo Notoatmodjo, Pendidikan dan Perilaku Kesehatan. Rineka Cipta, 2003.
[12] R. B. Dame, L. T. Kumaat, and M. L. Laihad, “Gambaran Tingkat Pengetahuan Perawat Tentang Code Blue System di RSUP Prof. Dr. R. D. Kandou Manado,” e-CliniC, vol. 6, no. 2, 2018, doi: 10.35790/ecl.6.2.2018.22176.
[13] Hikmah Lia Basuni, “Basic Life Support,” in Asuhan Kebidanan Kegawatdaruratan Maternal dan Neonatal, CV. Media Sains Indonesia, 2023, pp. 101–115.
[14] AHA, “Highlights of the 2020 American Heart Association Guidelines For CPR and ECC,” Am. J. Hear. Assoc., no. 9, p. 32, 2020.
[15] S. Hidayat and Y. Peristiowati, “The Influence of Nurse Knowledge Level on Compliance Implementation of Early Warning Score and Code Blue System in the Inpatient Room,” vol. 12, no. 2, pp. 137–144, 2023.
[16] S. E. Eroglu, O. Onur, O. Urgan, A. Denizbasi, and H. Akoglu, “Blue code: Is it a real emergency?,” World J. Emerg. Med., vol. 5, no. 1, p. 20, 2014, doi: 10.5847/wjem.j.issn.1920-8642.2014.01.003.
[17] K. E. Sahin, O. Z. Ozdinc, S. Yoldas, A. Goktay, and S. Dorak, “Code Blue evaluation in children’s hospital,” World J. Emerg. Med., vol. 7, no. 3, p. 208, 2016, doi: 10.5847/wjem.j.1920-8642.2016.03.008.
[18] S. Monangi, R. Setlur, R. Ramanathan, S. Bhasin, and M. Dhar, “Analysis of functioning and efficiency of a code blue system in a tertiary care hospital,” Saudi J. Anaesth., vol. 12, no. 2, pp. 245–249, 2018, doi: 10.4103/sja.SJA_613_17.
[19] Menteri Kesehatan Republik Indonesia, Standar Pelayanan Minimal Rumah Sakit. 2008.
[20] Ekwantoro, K. R. Putra, and Setyoadi, “The factors correlated to nurses’ decision activating code blue team in hospital,” Int. J. Public Heal. Sci., vol. 10, no. 1, pp. 202–206, 2021, doi: 10.11591/ijphs.v10i1.20574.
[21] R. Jackson, Janet E. MS, RN; Grugan, Amy S. MSN, “Code Blue, Do you know what to do ?,” Nursing (Lond)., vol. May, no. 45(5), pp. 34–9, 2015.