Pediatric Code Blue: How Prepared Are We? A Self-Efficacy Assessment Project
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Updated: Dec 19, 2025

Setup and Execution Of the Blindfolded Code Training Exercise
Published on: March 29, 2019
Prashant J Purohit1, Laurie Yamamoto1, Len Y Tanaka1
1Department of Pediatrics and Division of Pediatric Critical Care at Kapi'olani Medical Center for Women and Children, Honolulu, HI and Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI.
Abstract:
Pediatric advanced life support (PALS) recertification every two years is inadequate to maintain proficiency. The authors hypothesized that a standardized, recurring curriculum may enhance retention of cardiopulmonary resuscitation (CPR) skills. Monthly in situ mock code training and an annual online self-directed learning module were implemented for pediatric intensive care unit nurses, pediatric residents, and respiratory therapists at a women and children's hospital. The in situ mock codes were linked to PALS training self-efficacy (pre- and post-mock code) and feedback related surveys. CPR knowledge was assessed using an online module with pre- and post-tests. A total of 82 in situ mock code surveys and 137 online modules were completed over a 20-month period. Medical knowledge (P < .05 for 7/10 questions) and self-confidence improved (P < .001. Several staff reported a negative impact on their patient care assignments in order to participate in the mock code. However, a significant number of participants (65%) concurred with the benefits of monthly mock codes. The curriculum improved CPR efficacy by improving knowledge-based retention as well as self-confidence in their skills.
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