.jpg "Lauren Alessi, MD photo")
Lauren Alessi, MD
Clinical Assistant Professor
Helen DeVos Childrens Hospital
Grand Rapids, MI
Disclosure information not submitted.
.jpeg.jpg "Jonathan Pelletier, MD photo")
Jonathan Pelletier, MD
Clinical Instructor
Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Disclosure information not submitted.
Christina Jockel, MSN, RN, CCRN
Programmatic Nurse Specialist
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Lindsay Farione, BSN, RN, CCRN
Nursing Clinician
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Todd Spencer, MSN, RN, CCRN
Nursing Clinician
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Siriwattana Vehovic, MSN, RN, AC-PNP, FNP
Acute Care Pediatric Nurse Practitioner
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Bradley Kuch, MHA, RRT-NPS, FAARC
Director, Respiratory Care Services and Transport Team
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Alicia Au, MD
Assistant Professor, Critical Care Medicine. Associate Medical Director, PICU
Children's Hospital of Pittsburgh of UPMC, United States
Disclosure information not submitted.
Rajesh Aneja, MD, FCCM
Professor, Pediatrics and Critical Care Medicine. Medical Director, PICU.
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Melinda Hamilton, MD, MS
Associate Professor of Critical Care Medicine & Pediatrics. Program Director, PCCM Fellowship
UPMC Children's Hospital of Pittsburgh, United States
Disclosure information not submitted.
Title: Pediatric Intensive Care Unit (PICU) COVID Mock Codes Improve Provider Knowledge
Introduction: The COVID-19 pandemic generated new concerns in safety, including minimizing healthcare worker exposure during resuscitation and airway management. Simulation has the potential to improve communication and reduce exposure of healthcare providers and equipment. Our objective was to implement a standardized protocol for intubation and resuscitation of a patient suspected or confirmed to have COVID-19 in the PICU, which we hypothesized would improve providers’ knowledge, communication, and sense of safety.
Methods: We performed a targeted needs assessment for managing pediatric COVID-19 positive/suspected patients during codes and intubations. We developed protocols for both scenarios using a multidisciplinary approach with physicians, advanced practice providers (APPs), respiratory therapists, and nurses, including essential personnel and equipment inside and outside of an isolation room. Mock codes were conducted to identify potential barriers to patient and provider safety, immediately followed by a debriefing to gain feedback. We used a plan-do-study-act model to improve the process. Post-intervention, a questionnaire evaluated provider knowledge and attitude regarding safety. We compared knowledge scores between mock code attendees versus non-attendees, using Wilcoxon Rank Sum test.
Results: Survey response = 88, 18 (20.5%) physicians, 56 (63.6%) nurses, and 14 (15.9%) respiratory therapists. 31/88 (35.2%) respondents had participated in a COVID mock code. Of those, 96.3% felt the COVID mock code improved their sense of safety. And, 87.5% thought that the COVID mock code improved communication. Respondents who participated in mock codes performed significantly better on post-intervention knowledge assessments of appropriate equipment utilization and personnel roles (p=0.014, p=0.034).
Conclusion: Multidisciplinary mock codes in the PICU improve providers’ knowledge of appropriate equipment utilization and personnel roles, which may reduce equipment contamination and staff exposure, thereby potentially decreasing costs. These mock codes also have the potential to improve providers’ communication and sense of safety in this unique time. We plan to assess retention of this knowledge, equipment conservation, and cost savings in future studies.