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arrest.18 Our study revealed that though response time to Code Blue calls did not affect the immediate success rate, the success of resuscitation was better in terms of survival at discharge in cases where response time was within 3 mins. This was consistent with other studies as well.19 LIMITATIONS This study included only the adult ‘Code Blue’ calls. ‘Code Blue’ calls in this study included situations of cardiac arrest outside Emergency, Critical Care Units and the Operation Theatre which had stationed staff trained in Advanced Cardiac Life Support Systems. Hence success of resuscitation services across the hospital could not be evaluated. Condition of cerebral function was not reviewed as a parameter for successful CPR. As it was a retrospective study, the quality of resuscitation services like effectiveness of chest compression during CPR, delays in airway control and complication rate following CPR could not be analyzed. CONCLUSION Though the immediate success rate of Code Blue calls was quite high, it decreased by more than 50% by the first 24 hours with survival at discharge being 9.01%. Formal training of all the healthcare providers on BLS is of paramount importance. Further in depth analysis is required to find out the root cause of the problems that are associated with the ‘Code Blue’ process which is affecting the success rates beyond routine hospital working hours. REFERENCES 1. Eroglu SE, Onur O, Urgan O, Denizbasi A, Akoglu H. Blue code: Is it a real emergency?. World J Emerg Med. 2014;5:20–23. 2. Al-Aboud KM, Al-Aboud DM. Hospital emergency codes. An appraisal. Saudi Med J. 2010;31:1377. 3. Barbetti J, Lee G. Medical emergency team: A review of the literature. Nurs Crit Care. 2008;13:80–5. 4. Ali B, Zafari AM. Narrative review: cardiopulmonary resuscitation and emergency cardiovascular care: review of the current guidelines. Ann Intern Med. 2007; 147:171–179. 5. Sandroni C, Nolan J, Cavallaro F, Antonelli M. Inhospital cardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med. 20  Code Blue: Do You Know What To Do? In 2020, a not-for-profit hospital in the East Bay Area experienced 21 true code blue events amongst the four medical-surgical units. While 21 events may seem insignificant for an entire year, to the nurses, doctors, and most importantly the patients those events were the most terrifying experiences of their lives. The definition of a code blue is “any patient with an unexpected cardiac or respiratory arrest requiring resuscitation and activation of a hospital alert” (Eroglu et al., 2014). This means that a patient’s heart or lungs stop working suddenly, requiring hospital staff to act within minutes to bring them back to life. The skills and training required to be able to perform lifesaving procedures such as cardiopulmonary resuscitation (CPR) and external defibrillation are taught based on the American Heart Association’s guidelines for Basic Life support (BLS). Nurses and other healthcare professionals are required to renew this certification every two years in order to work at a hospital in the United States. However, recent research has shown that this biannual training is not sufficient to maintain competence of the necessary skills to revive a patient in cardiac or respiratory arrest. Looking back, those 21 code blue events could prove extremely dangerous to patients and their survival if nurses are not adequately prepared to intervene if their patient experiences cardiac or respiratory arrest. This project therefore poses the following PICOT question: For medical-surgical nurses, how does in-situ mock code blue training between BLS recertification periods affect nurse readiness and confidence in a code blue situation? Problem Description The American Heart Association requires that nurses renew Basic Life Support certification every two years. However, evidence has shown that response times and CPR skill CODE BLUE: DO YOU KNOW WHAT TO DO? 5 competency significantly decrease as early as three months after training is completed (Huseman, 2012.) While this need for more routine training was the driving force behind this project, several contributing factors were identified in a fishbone diagram (see Appendix A). In discussing the problem with administrators and nurse educators, three main themes emerged as crucial factors in increasing code readiness. One of the main priorities of the hospital administrators was to provide hands-on training for staff to interact with the Zoll Defibrillator. Another key point was to ensure team-based simulation to emphasize the importance of collaboration and communication. Lastly, it was vital to create a simple yet comprehensive guide of what actions to take in a code blue prior to the code team’s arrival (see Appendix B). The combination of these interventions provides nurses with the resources they need to be prepared for a code blue situation. Literature Review A comprehensive literature review was conducted in order to synthesize evidence that addresses the question: do in-situ mock code simulations increase medical-surgical nurse confidence and readiness for code blue situations? A search of the CINAHL database was conducted using the following search terms: mock code, code blue, nurse readiness, nurse confidence, medical-surgical 

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