Zuzana Sales

The Mount Sinai Hospital in New York

Abstract Title: Standardized mock code protocol using the Rapid Cycle Deliberate Practice (RCDP) model to improve nursing staff performance during cardiac arrest.

Biography: Dr. Zuzana holds a Bachelor of Science in Nursing and a Master of Science in Nursing with a specialization in Nursing Education from the University of Phoenix, Arizona, and a Doctor of Nursing Practice (DNP) from Aspen University, Arizona. She began her professional nursing career in Slovakia, gaining foundational experience within a universal healthcare system. Following her relocation to the United States, she joined Mount Sinai Beth Israel Health System in New York, where she expanded her clinical expertise across several high-acuity care settings, including neurosurgical step-down, coronary care, and critical care units. Dr. Zuzana later served as the lead transplant coordinator in collaboration with the Mount Sinai Health System and LiveOnNY organ procurement program, where she contributed to the coordination of organ donation processes and supported institutional transplantation practices. She currently serves as Director of Nursing Education at The Mount Sinai Hospital in New York, where she provides strategic leadership and oversight for nursing education programs, professional development initiatives, and competency-based training frameworks. Her work focuses on advancing evidence-based practice, strengthening workforce capacity, and promoting quality and safety outcomes through education and professional development. Dr. Zuzana is a member of the American Association of Critical-Care Nurses and the Association for Nursing Professional Development and holds the CCRN-K certification. She maintains a strong interest in global health and is committed to contributing to international efforts that advance education, professional capacity building, and equitable healthcare development.

Research Interest: Title: Standardized mock code protocol using the Rapid Cycle Deliberate Practice (RCDP) model to improve nursing staff performance during cardiac arrest. Background: In-hospital cardiac arrest events are high-risk, time-sensitive situations in which delayed recognition and defibrillation significantly reduce survival. Review of institutional resuscitation data identified prolonged time to defibrillation and variability in nursing performance on adult medical-surgical non-ICU units, associated with the absence of a standardized mock code protocol and inconsistent training methods. Local Problem: Time to defibrillation exceeded national benchmarks on two medical-surgical units, with mean response times well beyond the recommended two minutes, placing patients at increased risk for poor outcomes. Aim: This quality improvement project aimed to evaluate the effectiveness of a standardized mock code protocol using the Rapid Cycle Deliberate Practice (RCDP) model to improve nursing performance, specifically time to defibrillation during cardiac arrest. Methods: A quasi-experimental, one-group pre–post design was implemented in a 1,134-bed tertiary care hospital participating in the Get With The Guidelines®–Resuscitation initiative. Seventy registered nurses were organized into ten mock code teams. In situ RCDP simulations emphasized early arrest recognition, role clarity, high-quality CPR, and timely defibrillation through repetitive practice with targeted micro-debriefing. Time from arrest recognition to defibrillation (seconds) was measured pre- and post-intervention and analyzed using paired-sample t-tests. Results: Mean time to defibrillation improved significantly from 266.3 seconds pre-intervention to 75.2 seconds post-intervention (t = 7.172, p < .001), achieving compliance with national resuscitation guidelines. Improvements were observed across all groups. Conclusions: Standardized mock code training using the RCDP model significantly reduced time to defibrillation and improved nursing performance during simulated cardiac arrest. Embedding RCDP-based mock codes into onboarding and ongoing competency programs may enhance resuscitation readiness, reduce practice variability, and improve patient safety in non-ICU settings. Keywords: Cardiac arrest, Cardiopulmonary Resuscitation, Mock code, Rapid Cycle Deliberate Practice, Defibrillation