 The objective of this study is to determine if a novel resuscitation care improvement bundle that improved outcomes in a single center intensive care unit ICU efficacy study is generalizable to other pediatric institutions in a multi-center effectiveness trial. The ICU-Resuscitation ICU-RESUS bundle includes: 1 CPR training at the point-of-care in the ICU rather than a classroom away from patients; and 2 interdisciplinary structured reviews of each cardiac arrest that emphasize patient-centric physiology intended to optimize intra-arrest and post-arrest care. The ICU-RESUS bundle substantially improved CPR quality and nearly doubled the number of children surviving their event during the single center efficacy trial. In this study, a multi-institutional parallel stepped-wedge hybrid cluster-randomized trial, which leverages the existing infrastructure of the National Institute of Child Health and Human Development NICHD-funded Collaborative Pediatric Critical Care Research Network CPCCRN, is proposed with the following aims: 1 Evaluate the effectiveness of the ICU-RESUS interventional bundle to improve outcomes of children treated for an ICU cardiac arrest; and 2 Evaluate the effectiveness of the ICU-RESUS interventional bundle to improve the quality of CPR provided by ICU healthcare providers in the population of children treated for an ICU cardiac arrest. 