Date of Graduation

Fall 12-17-2021

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Robin Buccheri

Second Advisor

K.T. Waxman



Healthcare workers in the acute care setting must be ready to respond to emergencies at any given time. The recent COVID-19 pandemic put strains on the healthcare workforce that have brought challenges and new competencies for how healthcare workers safely respond to emergencies. To ensure healthcare workers maintain these competencies, specific training must occur to improve emergency response and outcomes. Specifically, there needs to be training for healthcare workers to respond to COVID-19 code blue emergencies safely and with skilled interventions.


A code blue in the acute care setting is a medical emergency that requires nurses, physicians, and respiratory therapists to react urgently and with precision to deliver life-saving interventions. Responders must be confident in performing their skills in this high stress environment. With the current COVID-19 pandemic, healthcare workers are tasked with caring for COVID-19 patients with additional precautions to avoid potential exposure to self and others.


Sixty-four healthcare workers (registered nurses, physicians, and respiratory therapists) participated in COVID-19 code blue simulation training. Each participant completed a pre- and post- survey to evaluate the simulation training. Data was collected on time to first chest compressions, first defibrillation, and first dose epinephrine from COVID-19 code blue case pre- and post- simulation training. Observations were done on COVID-19 code blue cases pre- and post- simulation training.


The purpose of this project was to develop, implement, and evaluate a simulation training class that allows for responders to safely practice their COVID-19 code blue skills including how to properly don and doff appropriate personnel protective equipment (PPE). This simulation training was provided to nurses, physicians, and respiratory therapist so they could practice their skills and responses to this life-threatening emergency.


COVID-19 code blue simulation training had a positive impact on healthcare workers knowledge, skills, and comfort levels that was statistically significant (p=


The project had a positive effect on healthcare workers safely conducting a code blue during the COVID-19 pandemic. While there were some limitations to the project, it is recommended that the organization continue the COVID-19 code blue simulation training with spread to all departments.

Keywords: Code blue, COVID-19, personal protective equipment, safety, simulation

Included in

Nursing Commons