Purpose: To discuss how the Code Review Taskforce of Children's Hospital at Birmingham, Alabama developed a competency tool to increase the practice and confidence of the nurses responding to cardiopulmonary arrest resuscitation codes.

Description of the Project: The primary problem was in maintaining competency of the nursing code skills during the code syndrome response. The "Code Syndrome Response" is how the mind and body react during the stress of a code. This response is due to the element of surprise, imminent threat to the patient and the short amount of time in which a nurse has to make decisions and act during a cardiopulmonary arrest. It was hypothesized that the nurses needed the opportunity to: 1) Demonstrate basic skills in cardiopulmonary arrest resuscitation and 2) Gain confidence in basic psychomotor skills through discussion, practice and feedback. Goal: To develop a program that allowed nurses the opportunity to practice the psychomotor skills involved in pediatric cardiopulmonary arrest resuscitation in a non-threatening environment.

Description of the Skill Station Plan: 1) Use the “Code Review Skills Lab Checklist” evaluation tool. 2) Use a pediatric code manikin and equipment/supplies needed for cardiopulmonary resuscitation 3) Use a patient simulation room 4) Staffed by a qualified instructor 5) Began the with a brief explanation of the objectives, and a demonstration of the psychomotor skills. 6) Allow opportunity for practice, participant feedback and instructor questioning 7) Require a return demonstration of the "Code Review Skills Lab Checklist” 8) A maximum of five participants 9) 30 minutes session 10) The "Code Review Skills Lab Checklist” is signed by the participant and instructor.

Outcome of the Project: (The conclusion and implications for Nursing Practice) The nurses successfully perfomed and verbalized increased self-confidence with the basic psychomotor skills for pediatric cardiopulmonary arrest resuscitation.