Title : Mini-mock codes: Beginnings matter
Abstract:
Mini-Mock Codes: Beginnings Matter discusses a process developed to enhance first responder performance of Basic Life Support (BLS). First responders are individuals who recognize a need and initiate BLS without the support of advanced providers. The American Heart Association (AHA, 2020) states that the action of the first responder is to provide early, high quality cardiopulmonary resuscitation (CPR). This project was initiated in response to direct observation of challenges of first responders at bedside emergencies and requests from staff for simulated cardiac arrest practice.
Effective, high-quality CPR has been identified as critical for patients to survive a cardiac arrest (The Joint Commission, 2021). However, loss of effective CPR psychomotor skills may occur within 3 months of training (Kaplow, 2020; Lim, 2021). In-hospital cardiac arrests result in over 290,000 annual deaths in US hospitals (Mota, 2023). In addition, biennial BLS skill validation may be insufficient to support the performance necessary to perform high quality CPR. With key stakeholder support, Nursing Professional Development Managers (NPDM),
challenged to improve clinician response to bedside emergencies, developed Mini-Mock Codes. This work enhances the AHA guidelines for basic life support recommendation to utilize deliberate practice & mastery learning to improve the quality of BLS.
During the pandemic, education needed to be brought to the nurses rather than requiring nurses to leave the unit for education. This low-tech method of allowing individuals to practice cardiopulmonary skills in their work environment has been well received by participants at a 171-bed Magnet with Distinction designated community teaching hospital. Mini mock code sessions were but impromptu responders. Required equipment includes feedback mannikin, cardiac rhythm simulator, defibrillator with training pads, a patient care area &/or stretcher. NPDMs utilized the feedback mannikin, a paper checklist, and a timer to record first responder actions during the event.
Set-up time for two NPDMs was 15 minutes; individual sessions for staff lasted 15 minutes. Staff were alerted to an unresponsive patient, and they responded; after 2 minutes, the mini mock code was paused for debrief. NPDMs provided feedback to the team based on direct observations, mannikin, and defibrillator data. Immediately following the debrief, participants re-enacted the code allowing for deliberate practice and repetition to improve performance. Post-session evaluations were completed.
