Implementing Multidisciplinary Mock Codes (MMCs) in a Level IV Neonatal Intensive Care Unit (NICU): Challenges and...

Simulation training in the neonatal intensive care unit (NICU) often occurs in silos with providers in different roles training separately.

With the recent growth in our NICU both in patient volume and new staff hires, we implemented multidisciplinary mock codes (MMCs) with the goal of improving NICU staff's comfort with real codes.

Program implementation, followed by a cross-sectional survey of NICU providers, predominantly nurses, 2 years after implementation to understand how providers are impacted by this program.

We conducted 60 MMCs from 2022 to 2024 in our level IV NICU. Key implementation challenges included designating institutional champions and engagement of key stakeholders. A total of 164 providers completed the postimplementation survey. Of the 108 providers who both participated in MMC and completed the survey, 65% reported that participation helped them prepare for real codes "quite a bit" or "significantly." Nurses who had participated in an MMC were less likely to report they were "not at all comfortable" participating in a real code ( P = .038). Of the 56 providers who completed the survey and had not participated in MMC, 84% indicated interest in future participation.

Regular MMCs can be implemented in the NICU, are desired by most providers, and improve provider comfort with real codes. This program may be especially useful for nurses with fewer than 5 years of practice experience but also offers benefits for more experienced providers. Further research is needed to understand the impact of this program on performance in real codes.