Mock Code

kmoonshine, RN · Mar 18, 2007

We just had a mock code at my workplace and we had to demonstrate compressions (correct depth and rate) and how to insert an intraosseous needle into an infant.

I'm not sure who your target audience is for the code competency (ie L&D nurses, floor nursing staff, students, etc), and I'm not sure if anyone in your target audience has participated in a code, which would change things a bit. I'd say for general floor staff, most who have not experienced a code, here are some things I'd include:

phone number to call for a code
basic CPR skills and new BLS guidelines
location and use of oxygen supplies/equipment
location of code carts in various parts of the hospital
location & application of CPR board
rationale for IV access and routes used during a code
applying monitor leads/patches
documentation during a code
use of portable suction
cracking a code cart: let everyone look through the cart, tell them which drawer to start with, what to set up for the team responding to the code (such as making sure the laryngoscope works), types of laryngoscope blades (I remember the different blades this way: "Macintosh is curved like an apple, Miller is straight like a pillar")
which code teams respond to various parts of the hospital (for example, I am in the ED where we respond to our own codes and codes in the parking structure)
the future of codes: for example, I would discuss I/O therapy and indications for it as well as the concept of hypothermia-induced CPR; some nurses may see these actually being implemented during CPR and should be prepared beforehand. And even though the staff wouldn't be initiating any of these, it still gets the gears turning and education is power ("Oh yeah, I can see why an I/O would be used since vascular access is poor" and "I can understand the importance of correct IV placement since some of the meds used during a code cause tissue necrosis").
family presence: while some facilities have policies for this, many of us find it difficult to console the family. Discuss the role of the nurse if family is present during a code (this is a very important role nurses may have while the code team is working on the patient).

Most importantly, let the staff play with the equipment, get familiar with the supplies, and ask questions. Take 2-3 nurses at a time, verbally trouble-shoot a code and how to respond, discuss the new BLS guidelines, and make it a learning experience rather than a test-taking environment.

I'm the type of nurse that likes to take off the peripheral blinders to examine the whole situation. If your target audience is like me, teach them and allow them to absorb the info so they can anticipate what the next "step" may be during a code. I started in the ED straight out of school, but when I was a student I had no idea what was in the code carts or what went on during a code. Now that I know what to do, where the supplies are, and what happens during a code I feel much more comfortable in my role.

Let me know how things go!

GIRN · Mar 18, 2007

If you're not in Education, Kmoonshine, you need to be! Great points! Taking the testing out of the situation and making it a learning environment is what you should strive for. The nurses really want to be good at Codes...take away the stress of making a mistake and add the information they need to make them more helpful during a Code and they'll love you for it! Tell them Mock Codes are the chance to learn this stuff before they need it in real life. We do that in our hospital now and everyone really appreciates the hands-on learning. Good luck!