Purpose:

This program was designed by a student clinical nurse specialist (CNS) to address a comfort level and knowledge level deficit with emergency and code situations among new graduate staff nurses and nurses having fewer than 3 years of experience working on a cardiac step-down unit.

Significance:

Bedside staff nurses, whose judgment is critical to early identification of patients showing signs of clinical decompensation, historically gain expertise with emergency situations through random repeated exposure to cardiac arrest and code situations during their scheduled shifts. Disaster-management and emergency resource-management literature describe success of structured communication process and simulation in training medical personnel for managing disasters. Applying these concepts while using low-tech resources, CNSs can raise comfort levels and knowledge levels of staff nurses faced with unexpected emergency situations.

Methods/Description:

Using the staff time-plan, groups of staff nurses were formed and presented a case study resulting in a theoretical emergency situation. Using a training code cart and an adult dummy, the "mock code" was repeated 2 times with a debriefing of the experience between simulations. The concepts of structured communication and the roles of medical personnel usually present at a code were reviewed. Emphasis was on the role of the bedside nurse as the universal constant and first responder. Pre- and post-mock code surveys have been done with each session, showing a raised comfort and confidence level after participation in the simulated sessions.

Findings/Outcomes:

Survey results indicate a consistent raised comfort and confidence level postsimulation. Differences were noted with respect to years and types of prior experience.