69 - STAT! Trauma Surgery and Code Blue High-Fidelity Simulation in the Operating Room

Description: Description of Team:
A multidisciplinary workgroup was formed consisting of perioperative educators, clinical nurse specialists, operating room (OR) nurses, and certified surgical technologists (CSTs). The team collaborated with trauma surgery leadership and anesthesia providers to design and implement a trauma/code blue simulation specific to the perioperative environment. The educational intervention targeted 110 OR staff members, including both experienced and novice team members.

Preparing and Planning:
The project was initiated to improve staff performance and self-confidence during high-stress scenarios such as STAT trauma surgeries and intraoperative code blues. A literature review supported the use of simulation in improving code response and time to defibrillation, though most studies focused on med-surg settings. No studies were found evaluating STAT trauma simulations in the OR, identifying a clear practice gap. The workgroup designed a two-part educational intervention: a lecture in the first week and high-fidelity hands-on simulation in the second.

Assessment:
In fiscal year 2023, the OR managed 295 STAT trauma cases, underscoring the need for improved preparedness. Staff confidence and rapid response are critical during intraoperative cardiac or respiratory arrest. Baseline knowledge, comfort, and response time were informally assessed through observation and staff self-report prior to the intervention.

Implementation:
The simulation featured a realistic trauma surgery scenario involving intraoperative cardiac arrest. Each participant group completed two simulations with a structured debriefing between sessions. The debrief focused on teamwork, communication, equipment access, and response times. Five separate simulation rooms were used to accommodate the training of 110 CSTs and RNs over the two-week period.

Outcome:
Post-simulation results showed measurable improvement. The average time to retrieve the crash cart decreased by 2 seconds, and the average time to defibrillate after loss of pulses improved by 20 seconds. Survey feedback indicated that 89% of staff felt the simulation improved their performance in clinical practice and increased their confidence in handling STAT trauma and code blue scenarios. Among staff with less than two years of experience, 100% reported the simulation was beneficial and recommended annual repetition.

Implications for Perioperative Nursing:
Trauma surgeries and intraoperative codes are among the most high-risk, high-stress events in the OR. Providing structured, high-fidelity simulations prepares perioperative nurses and CSTs to respond effectively, improving both team dynamics and patient outcomes. This initiative demonstrates that regular trauma/code simulation can serve as a vital educational tool to increase clinical confidence, reinforce critical thinking, and support a culture of preparedness in the perioperative setting.