Background: Agitation and behavioural disturbances in older inpatients impact patient safety and staff wellbeing. In Victorian hospitals, ‘Code Greys’ are coordinated rapid responses to de-escalate unarmed clinical aggression.
Aims: To describe and compare patient and Code Grey characteristics, and admission outcomes of inpatients aged ≥65 years who triggered multiple (≥3) versus single (1-2) Code Greys on general wards.
Methods: Single-centre retrospective cross-sectional study at a Victorian regional tertiary hospital. Patients with Code Greys between January and June 2024 were identified from electronic incident reporting system (RiskMan). Patient and event characteristics, and short-term outcome data were extracted from clinical records and analysed using Stata 15.
Results: Of 110 patients, 37 (33.6%) triggered multiple Code Greys accounting for 272 of 355 (76.6%) events. Mean ages of patients in Multiple and Single event groups were 81.6±7.5 and 79.2±7.5 years respectively. The Multiple event group had higher median admission 4AT score (8 [IQR,4-8] vs 4 [IQR,2-7], p=.005). Younger age and higher 4AT score were associated with higher number of events. Patients with multiple events were significantly more likely to receive restraints during Code Greys (OR 31.38, p<.001), had longer mean length of stay (12.15 days difference [95% CI, 3.12-21.18], p=.01), and higher odds of discharge to residential aged care facilities (OR 3.59 [95% CI, 1.27-10.15], p=.02).
Conclusion: Older inpatients with multiple Code Greys demonstrated higher 4AT score, greater restraint requirement, longer hospitalisation and increased institutionalisation. Greater effort is required to better understand these distinct and vulnerable patient population who may require different care approach.