Code White in Hospitals: What Does This Mean for You?

• Have you seen an increase in code white statuses in healthcare facilities nationwide?  
• A code white status is typically called when a person within the facility begins behaving violently. 
• How would you handle a code white in your facility?

Have you seen an increase in code white statuses in healthcare facilities nationwide?  

Or are you curious about what this code entails and what criterion must be met for it? 

Whatever the case may be, we have the answers you’re looking for.

Please note that not all hospital codes are universal, and what might constitute a code white in one facility, might not for another.  

Code White: What Can This Mean?

Some facilities may declare code white statuses during neonatal emergencies, emergent evacuations, or when medical assistance is needed for a non-patient.  

However, one of the more recent (and common) criteria for a code white declaration is when a person within the facility begins behaving violently. 

With the prevalence of workplace violence increasing each year, nurses and other members of the healthcare team are at risk. Code white statuses are just one of many protocols set to minimize the potentially dangerous outcomes of a combative patient or guest.

Of course, these protocols also protect patients and their families.  

What Should I Do During a Code White?

Protocols during a code white can vary per healthcare facility.  

However, if you are in a situation where a patient is acting violently, there are a few universal moves you can make. 

De-escalation techniques

The Joint Commission (TJC) offers several tips for healthcare providers who are in a situation that they must de-escalate for the safety of patients and staff. These include: 

• Using verbal communication techniques that are clear and calm.  
•  Maintaining non-threatening body language when approaching the patient. 
• Approaching the patient with respect and being supportive of their issues and problems. 
• Using risk assessment tools for early detection and intervention. 
• Implementing environmental controls, such as minimizing lighting, noise, and loud conversations. 

Call for a code white or your facility’s equivalent

If the de-escalation techniques listed above are not applicable for your patient and their level of agitation, it is vital that you call a code white.  

Your nearby colleagues will be able to assist you by following your facility’s protocol when handling moderately and severely agitated patients who are combative.  

Notify hospital security

More often than not, hospital facilities have security guards (mostly for instances such as a code white).  

Depending on your facility’s procedure, if you can contact security to assist you, we recommend doing so, as it can provide you and others with protection.  

Restraints

Although we are not going to get into the specifics of the many types of restraints a provider may use in the event of a severely agitated and combative patient, it is important that we cover this. Restraints will also be covered in your facility’s code white protocol, so be sure to check that out, too.

This form of intervention not only protects providers and those around a combative patient, but they also protect the patient from harming themselves.  

A few examples of physical restraints can include railing, sheet tucking, or wrist, ankle, and waist restraints. 

There is controversy surrounding the use of restraints, as there are many existing alternatives that serve the same purpose. However, this is up to your facility.  

The Bottom Line

During a code white, the best thing that you can do is to follow the protocol and procedures outlined by your healthcare facility.  

Acts of violence within the walls of a healthcare facility will never be able to be fully stopped. However, it is important that you are as prepared for them as possible. 

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