Creating a Mock Code

[mikijam03lpn]

Hi everybody

I need some help creating a mock code for some of my floor nurses. I work as LTC nurse educator/resource nurse, I been in LTC for 7 years, but this last year I been working in the ER in a Trauma Center in North Jersey. So I have more experience with critical ill patients, and codes (etc...). The reason why I want to create a mock code for my floor nurses, its because we mostly have brand new nurses that have no clue. I would really appreciate your input. We do have a crash cart, AED,IV's and emergency medications (dextrose, glucagon, epi, etc....).

Thank You

[CoffeeRTC, BSN, RN]

We've never had a practice code, but it is a good idea especially in the off shifts when there are less staff.

Look at the type of residents that you do have some scenarios...diabetic shock (too low, too high), MI, CVA, fall with trauma (head, displaced bones).

Remember that in LTC, there are no protocols for meds unless you already have them ordered. (nitro, glucagon, narcan etc) Technically you can't even apply hi flow O2.

I'll be interested to follow and see what others have been doing.

[amoLucia]

I worked one place where we actually had mock 'fires', not just fire drills when everybody just runs to the codesite, wing, corridor, etc. A big 'FIRE CARD' would be set up and the first employee to see it initiated a real 'fire response' (accdg to PACE/RACE steps).

The Pt was really rescued, the fire Alarm was really pulled, the fake 'fire' would be Contained, and then pts in the area were really Evacuated. We did the whole nine yards! And the other departments were really expected to respond appropriately.

Boy! I could have fun with your idea. Assuming your nurses 'KNOW' their pts, you could set up similar real pretend scenarios using a pretend doll/teddy bear, etc in different facility areas, Therapy, kitchen. front lobby, patio, etc. Boy, I could see red jello used as blood!!!

In most places I've been, the word "STAT" was NEVER used EXCEPT to intercom out for "NURSING SUPVISOR to Main Dining Room STAT". That was the cue that there was a code emergency. Any nurse available would respond and the unit with the AED would bring it. All the units had crash carts with O2 & suction setups and each had an Ebox, altho there was only 1 IV box.

Come to think of it, though, I don't remember any facility P&P that was written out in the big P&P Manual. You'd need that, inservice it and then run your codes.

As another PP commented, you would really need some in-house protocols that are NOT the high-end acute level, just what would match your in-house skills and state scopes of practice.

Oh, and just another idea. 'Mock Surveys'. Another place actually ran surprise 'Mock Surveys". Staff employees (NOT the dept heads - were selected to be 'the surveyors'. It was a learning experience and surveyors were expected to be professional and not to be 'getting even' or smarty. Pt privacy & dignity was always maintained, but all things could be observed - overflowing trash rooms, trays missing adaptive equip & wrong items, pts with dirty fingernails, ratty wheelchairs, broken window blinds, etc, etc. Nurses would look at charts and care plans for pts on different units. Some major HIPAA infractions were caught by 'surveyors'.

Non-nsg employees were prepped on how to look for things, and all were ABSOLUTEY FORBIDDEN to reveal the date of 'survey'. They were expected to 'dress up' like for real survey, they could come in at a later designated time, and they could go out for a nice lunch. They enjoyed the experience! And it was never abused to my knowledge.

Just some ideas.

[CapeCodMermaid, RN]

We have mock codes every now and then. We page "Code Blue" to where ever the 'patient' is and wait for the response. I am usually the patient and try not to laugh when I hear my staff say "OH NO....it's Cape Cod Mermaid...we LIKE her!" It may be silly but they respond in a timely manner and know what to do when they arrive on the scene. I do, however, draw the line at them sticking the AED on me!