Purpose for the program:  The Women's Center at UCH has been participating in postpartum hemorrhage drills and shoulder dystocia drills for the last year.   Maternal Code drills have been discussed for many years and it was time to take action.

Proposed change:  UCH came up with a plan to begin Maternal Code Drills in the LDR unit.

Implementation, outcomes and evaluation: To implement Maternal Code drills at UCH, we had to first come up with a game plan. The best way to formulate a plan was to have an interdisciplinary approach. The Director, Nurse Manager, Team Leaders, Clinical Nurse Coordinator, Anesthesiologist and Obstetrician all met to do a walk through in an LDR room for the drill. Role cards were created for the Primary Nurse, Team Leader, Additional RN's, Unit Secretary, Anesthesiologist, Obstetrician and Nurse Tech. The Policy for Cardiopulmonary Resuscitation in the Obstetric Patient was revised to reflect the role definitions. Once the policy was reviewed and signed off by the Chief of OB and one of our Perinatologist, the policy went to the critical care committee for final approval. Now, we could start working on staff education. A Power Point Presentation was created, printed and placed in a notebook for a month. The entire staff had the opportunity to review, prepare and ask questions about the upcoming drills. Next, it was time to get to the details of the drills. The code cart used for hospital wide staff training was extremely outdated. It took a days work and the help of central supply to get the cart in order for the first drill. Another problem we encountered, we didn't have a manikin. With the help of one of the Team leaders, a pregnant belly was hand sewn that fit on the torso of a CPR manikin. Once a blonde wig was added and a hospital gown, we had our patient. In July 2011, the Women's Center ran 10 maternal code drills. The drills were a huge success and all team members were able to acquire valuable experience to improve patient safety.

Implications for nursing practice: Being prepared for High Risk, Low Volume emergencies has been the subject of many articles and research. However, actually getting started and motivated to run drills is not always easy. It's time to stop talking about it and implement Maternal Code drills at your facility.

Keywords: Maternal Code Drills, Cardiopulmonary resuscitation, Primary Nurse