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Five Alive: Using Mock Code Simulation to Improve Responder Performance During the First 5 Minutes of a Code

Delac, Kathy MSN, RN, CNS; Blazier, Diane BSN, RN; Daniel, Laura PhD; N-Wilfong, Donamarie DNP, RN

doi: 10.1097/CNQ.0b013e3182846f1a
Original Articles

Purpose: This article reviews the institution of mock code simulation training to improve registered nurses responder performance at a trauma 1 teaching hospital.

Method: An in-situ mock code is held on random medical-surgical/telemetry units every month. Participants are asked to respond to 2 different scenarios using a 3-G Sim Man and the unit's emergency equipment. Each session is followed by debriefing, postsurveys, and evaluation. The time to cardiopulmonary resuscitation (CPR) and defibrillation is recorded for analysis. The participant's level of confidence is measured before and after simulation.

Results: More than 250 nurses have participated in the Five Alive course since its initiation in March 2011. The participants have expressed more confidence in recognizing a declining patient health status after the simulation. They have also demonstrated a marked improvement in time to CPR and defibrillation.

Conclusions: Initial findings reveal that in-situ medical emergency team/code simulation followed by debriefing improved the performance of responders. We are currently offering the Five Alive program monthly during four 1-hour sessions and have found this program to be an effective training tool. There is one challenge to offering the program on the off shift and weekends. That is finding a time that is not too disruptive to patient care.

Department of Professional Practice, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Correspondence: Kathy Delac, MSN, RN, CNS, Department of Professional Practice, Allegheny General Hospital, 320 E N Ave, Pittsburgh, PA 15212 (

The authors thank the team at the Simulation, Teaching, and Academic Research Center (STAR) at West Penn Allegheny Health System for supporting the development, implementation, and quality improvement activities for their in-situ mock codes.

The authors have disclosed that they do not have any significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Lippincott Williams & Wilkins, Inc.