Developing a Code Blue Simulation Experience in Labor and Delivery

Over 700 women die each year due to pregnancy and delivery complications and most of these maternal deaths could have been prevented. It is imperative that Labor and Delivery nurses are prepared for a medical emergency to provide the best care possible. The purpose of this continuous improvement project was to develop a Code Blue simulation experience to increase Labor and Delivery nurses' comfort, competence and confidence in a Code Blue medical emergency. The pre-survey consisted of three demographic questions followed by eight informational questions to assess the nurses' perception of their role in a Code Blue as well as their perceived skill level. The 34 nurses in the Labor and Delivery department were divided into four groups to attend one day of the Bi-Annual Skills training. Labor and Delivery nurses participated in Code Blue simulation training which allowed the nurses to experience their role in a Code Blue situation. Roles and responsibilities were determined by the manager and learning specialist in Labor and Delivery with input from the Code Blue team at the hospital facility. Debriefing provided opportunities for expression of concerns, accomplishments and ways to improve. The post-survey consisted of the same questions as the pre-survey and demonstrated an increase in the nurses' comfort level, competence and confidence in a Code Blue situation. The majority of nurses at 70.5% responded they were strongly not confident, somewhat not confident or neutral to the question of how confident they felt in a Code Blue situation. Only 29.4% felt somewhat confident or strongly confident. Post-survey results showed 88.3% felt somewhat confident and strongly confident. In regards to competence, 58.8% felt strongly not competent, somewhat not competent and neutral with 35.3% feeling somewhat compete and only 5.9% feeling strongly competent. Post-survey results showed an increase to 41.2% feeling strongly competent with 50% feeling somewhat competent and 8.8% at neutral. The largest margin was Developing a Code Blue Simulation Experience 3 82.3% who felt strongly not comfortable, somewhat not comfortable and neutral in how comfortable they felt in a Code Blue situation. Only 17.6% felt somewhat comfortable or strongly comfortable. Post-survey results showed 85.3% felt somewhat comfortable and strongly comfortable. Comparison results from pre-survey and post-survey demonstrate that simulation training is an effective method of nursing education to improve the skills of the Labor and Delivery nurse.