1. Mock Codes Lead to real Results Paris Hotel and Casino  Las Vegas, Nevada Presented by: Bridgid G. Joseph BSN, MSN, CCNS

2. Presenter Disclosure Information Bridgid G. Joseph Mock Codes Lead to Real Results FINANCIAL DISCLOSURE:  No relevant financial relationship (s) exist

3. If you don’t use it, you lose it

4. Background Previous mock codes on units lasted over an hour Simulation Center: 3 hour mock code team training monthly Fewer actual Code Blue events within our hospital

5. Intervention Created a New Formalized Mock Code Program: 1 mock code on each unit monthly All unannounced to floor staff Covered all shifts Mock codes consist of a training and debrief Last a total of 10 minutes Focused educational exercise

6. Mock Code Details Start with an unresponsive patient Training Code cart available at site Fully stocked mimicking our code carts Training medications/bristojets used. Patients in a shockable rhythm VFib, pulseless VTach

7. Mock Code Details Recognition of Arrest Position of bed and patient CPR AED Code Cart Emergency Medications Debrief

8. Expansion of Focus Able to assess other hospital-wide initiatives during the response to these exercises: Alarm Fatigue: Staff response to low level telemetry alarms (leads off alarms) Hand hygiene: ensure all secondary responders used cal STAT, gloves, appropriate PPE Teach code cart/code team policy changes during debrief Team training: working together and communicating

9. Results 2011

13. Adjusted for time to first responder

17. Pitfalls Time Staff buy-in Increased Census Alarm Fatigue Staff recognition Off Shifts

19. Conclusion Overall a successful program: Improvements : Significant improvement in overall code cart knowledge, use of AEDs, and medication location and use. Staff starting CPR immediately, able to defibrillate quickly, and have epinephrine ready and administered quickly. Anecdotally: Staff report feeling more confident Working better as teams Asking for mock codes Sneers have turned to cheers!!