Implementing Multidisciplinary Mock Codes (MMCs) in a Level IV Neonatal Intensive Care Unit (NICU): Challenges and Participant Feedback. Adv Neonatal Care 2026 Apr 01;26(2):158-165
Date
03/06/2026Pubmed ID
41785848DOI
10.1097/ANC.0000000000001347Scopus ID
2-s2.0-105034681573 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Simulation training in the neonatal intensive care unit (NICU) often occurs in silos with providers in different roles training separately.
PURPOSE: 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.
METHODS: 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.
RESULTS: 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.
IMPLICATIONS FOR PRACTICE AND RESEARCH: 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.
Author List
Mitchem T, Cabacungan E, Gupta R, Welak S, Rholl E, Sprecher A, Berlin K, Schuster J, Acharya KAuthors
Krishna Kartikey Acharya MPH, MBBS Associate Professor in the Pediatrics department at Medical College of WisconsinKathryn Berlin DO Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Erwin Cabacungan MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin
Ruby Gupta MBBS Associate Professor in the Pediatrics department at Medical College of Wisconsin
Erin Rholl MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Scott R. Welak MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Cross-Sectional StudiesHumans
Infant, Newborn
Intensive Care Units, Neonatal
Neonatal Nursing
Patient Care Team
Simulation Training
Surveys and Questionnaires
