Mission Accomplished!  Nurses in the Obstetrical Unit Profess Increased Confidence After CompletingAdvanced Cardiac Life Support (ACLS) Mock Code Drills Using a Human Patient Simulator
           An innovative program of ACLS review and nursing education was developed utilizing a human patient simulator for offering ACLS Mock Code drills in the obstetrical unit of a busy Level 3 free-standing women’s hospital in an attempt to improve patient safety and staff confidence. Even though many obstetrical nurses are certified as ACLS providers, many have never had the opportunity to put their training into use because cardiac and respiratory arrest are such rare occurrences in obstetrical units.  As with other rare occurrences, the anticipation and fear of performing badly can cause undo stress and anxiety during the actual event.  It has been well documented that nurses and medical staff have poor knowledge and skill retention following cardiopulmonary resuscitation training.  This program was designed to advocate best practice by increasing staff knowledge related to role performance when an obstetrical patient experiences cardiac or respiratory arrest and to improve staff confidence in their ability to recognize cardiac rhythms and initiate appropriate treatment using Emergency Standing Orders. 

Development of this project was challenging due to the fact that none of our staff members were experienced in using the human patient simulator for any drills, much less a complex Advanced Cardiac Life Support mock code.  A large amount of time was spent familiarizing the team with the simulator computer and programming the simulator for an obstetrical cardiac scenario.  Eventually, the team was divided to provide both computer operators and mock code leaders at each drill.  Short-term success has been documented through the use of pre and post ACLS mock code drill surveys which indicate a significant improvement in staff members’ comfort level related to identifying cardiac rhythms and initiating appropriate treatment using the hospital’s Emergency Standing Orders standardized procedure.  A recent patient’s cardiac arrest in the obstetrical unit offered the opportunity to put our hospital’s training to the test, and though the staff reported anxiety related to the situation, they reported (and demonstrated) overwhelming confidence and high level of nursing practice.  Implications for the future include involving other disciplines such as anesthesia and pharmacy in our ACLS Mock Code drills and expanding the use of the human patient simulator to other high-risk/low frequency drills.