{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:38:37Z","timestamp":1781253517290,"version":"3.54.1"},"reference-count":10,"publisher":"AACN Publishing","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"\n Background<\/jats:title>\n Evidence demonstrates that shocking patients in ventricular fibrillation or pulseless ventricular tachycardia in 2 minutes or less leads to improved outcomes. At our facility in Orlando, Florida, 4 of 7 time to first shock fallouts occurred in the intensive care unit. No standardization for conducting code situations existed in the intensive care unit.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To develop nurse simulation education and training to standardize intensive care unit code processes and improve compliance with timely defibrillation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The sample consisted of intensive care unit nurses. Interventions included online education, simulation, and a postintervention survey. Analysis was conducted using the Get With the Guidelines program as well as descriptive statistics.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Online education assigned to all intensive care unit nurses included electrocardiogram recognition and code documentation. Nurses and physicians collaborated to develop a diagram to identify roles needed for successful conduct of a code situation. A code simulation video was created, reflecting these roles, and embedded in the online education. The education was graded and remediated one-on-one with nurses. Intensive care unit nurses completed structured code simulations, allowing them to practice serving as the leader. Three months after the intervention, a survey was distributed to nurses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The time to first shock fallouts in the intensive care unit decreased by 100%, and the facility\u2019s fallouts decreased by 71%. The facility\u2019s adherence to the time to first shock metric increased from 42% to 83%. In a postintervention survey, 89% of nurses reported perceived improvement in knowledge, team leadership and communication, and confidence associated with code events.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Online education and code simulation positively affected time to first shock in code situations and empowered nurses to confidently function in these situations.<\/jats:p>\n <\/jats:sec>","DOI":"10.4037\/ccn2021596","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T18:03:04Z","timestamp":1638381784000},"page":"62-68","source":"Crossref","is-referenced-by-count":3,"title":["Using Simulation to Improve Adherence to Get With the Guidelines Time to First Shock"],"prefix":"10.4037","volume":"41","author":[{"given":"Andrea","family":"Paddock","sequence":"first","affiliation":[{"name":"Andrea Paddock is a clinical nurse specialist in the cardiac progressive care unit, Dr. P. Phillips Hospital, Orlando Health, Orlando, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"12","key":"2021120115472742400_b1-0410062","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1001\/jama.2019.1696","article-title":"In-hospital cardiac arrest: a review","volume":"321","author":"Andersen","year":"2019","journal-title":"JAMA"},{"issue":"6","key":"2021120115472742400_b2-0410062","doi-asserted-by":"publisher","first-page":"e82","DOI":"10.1161\/CIR.0000000000000583","article-title":"Resuscitation education science: educational strategies to improve outcomes from cardiac arrest: a scientific statement from the American Heart Association","volume":"138","author":"Cheng","year":"2018","journal-title":"Circulation"},{"key":"2021120115472742400_b3-0410062","unstructured":"American Heart Association\n . Get With the Guidelines-Resuscitation fact sheet. May\u20082017. Accessed August 5, 2021. https:\/\/www.heart.org\/-\/media\/data-import\/downloadables\/1\/c\/b\/gwtg-r-fact-sheet-ucm_434082.pdf?la=en"},{"issue":"1","key":"2021120115472742400_b4-0410062","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.auec.2020.08.005","article-title":"Effectiveness of simulation-based cardiopulmonary resuscitation training programs on fourth-year nursing students","volume":"24","author":"Demirtas","year":"2021","journal-title":"Australas Emerg Care"},{"issue":"5","key":"2021120115472742400_b5-0410062","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3928\/00220124-20200415-07","article-title":"Effects of a simulation-based CPR training program on knowledge, performance, and stress in clinical nurses","volume":"51","author":"Sok","year":"2020","journal-title":"J Contin Educ Nurs"},{"issue":"9","key":"2021120115472742400_b6-0410062","first-page":"222","article-title":"Education coupled with in-situ high fidelity simulation improves medical-surgical RN code blue comfort levels","volume":"113","author":"Wallace","year":"2017","journal-title":"J Ark Med Soc"},{"issue":"5","key":"2021120115472742400_b7-0410062","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/NUR.0000000000000237","article-title":"Two hours of teamwork training improves teamwork in simulated cardiopulmonary arrest events","volume":"30","author":"Mahramus","year":"2016","journal-title":"Clin Nurse Spec"},{"key":"2021120115472742400_b8-0410062","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.pedn.2017.12.006","article-title":"The effect of high fidelity simulators on knowledge retention and skill self efficacy in pediatric advanced life support courses in a rural state","volume":"39","author":"Stellflug","year":"2018","journal-title":"J Pediatr Nurs"},{"issue":"1","key":"2021120115472742400_b9-0410062","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/DCC.0000000000000394","article-title":"An initiative using simulation to aid in retention of advanced cardiac life support knowledge and skills in an emergency department nurse residency program","volume":"39","author":"Campbell","year":"2020","journal-title":"Dimens Crit Care Nurs"},{"issue":"16 suppl 1","key":"2021120115472742400_b10-0410062","doi-asserted-by":"publisher","first-page":"S242","DOI":"10.1161\/CIR.0000000000000277","article-title":"Part 8: education, implementation, and teams: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment recommendations","volume":"132","author":"Bhanji","year":"2015","journal-title":"Circulation"}],"container-title":["Critical Care Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/41\/6\/62\/139424\/62.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article-pdf\/41\/6\/62\/139424\/62.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T18:03:09Z","timestamp":1638381789000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ccnonline\/article\/41\/6\/62\/31620\/Using-Simulation-to-Improve-Adherence-to-Get-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,1]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ccn2021596","relation":{},"ISSN":["0279-5442","1940-8250"],"issn-type":[{"value":"0279-5442","type":"print"},{"value":"1940-8250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,1]]}}}