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Checklist for crash cart evaluation .
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INTRODUCTION: A crash cart or code cart /crash trolley "MAX cart" is a set of trays / drawers /shelves on wheels used in hospitals for transportation and dispensing of emergency medication/equipment at site of medical/surgical emergency for life support
protocols (ACLS/ALS) to potentially save someone's life.
AIM: To evaluate of availability and e...
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Citations
... 12 The common observed issues in this study are drained batteries, equipment failure, inappropriate size of equipment, and empty oxygen tanks. These issues are similar to those previously reported in the literature 43,44 and, in combination, may produce delays in providing emergency intervention 43 and compromise patient safety. Lack of situational awareness may be the contributing factor of these incidents. ...
Introduction
The periodic check of the function and integrity of the resuscitation cart is very important to ensure that the cart is prepared for use to provide emergency care to critical patients. Little is known about situational awareness during the periodic inspection of resuscitation carts. The purpose of this study was to measure hospital clinical nurses’ situational awareness immediately after completion of a check of the resuscitation cart content and to directly observe and assess the resuscitation cart readiness in the selected hospitals.
Methods
An observational correlational study with a self-report measure design was used in which the Situation Awareness Rating Technique was collected immediately after the completion of checking of the resuscitation cart.
Results
Among the 332 nurse participants, the mean situational awareness score was 16.42 (standard deviation 5.26), reflecting an average situational awareness during the task of checking and inspection of the resuscitation cart. Knowing the policies and guidelines relating to resuscitation and the resuscitation cart is associated with the participants’ situational awareness (F3,33 = 3.70, P = .04). In addition, working in critical areas and the number of years of working experience are associated with the participants’ situational awareness (F2,33 = 3.24, P = .04 and F3,33 = 3.002, P = .02, respectively). Assessing the resuscitation cart readiness revealed several issues such as empty oxygen tanks (32%); drained batteries and equipment failure (16%); incorrect size of equipment (16%); and missing, expired, and unavailable equipment (15%). Some of these issues were noted even though the carts were checked several times by different participants.
Discussion
Much work needs to be done, because inadequate situational awareness during the periodic check of the resuscitation cart content can affect patient safety in life-threatening emergencies.
... Quanto ao item Condições de Manutenção, cinco (26,3%) veículos foram considerados inadequados. Trata-se de fatores contribuintes para o atraso no tempo de resposta ao agravo do paciente (14,16) . Quanto à limpeza externa, as regiões de superfície (como a parte externa do CE) servem de meio para a propagação de patógenos quando não realizada a devida limpeza e desinfecção (17) . ...
... Além disso, o excesso desses materiais diminui o espaço para a organização dos demais, que acabam muitas vezes ficando de difícil localização dentro da gaveta. A gaveta deve comportar os materiais mínimos de acordo com o seu protocolo institucional, de forma ordenada, retirando-se os itens desnecessários e armazenando-se os indispensáveis (16) . Quanto à identificação das gavetas, é necessário que todas estas contenham meios de identificação visíveis, classificando--se os itens de cada compartimento para o rápido acesso (14) . ...
Objective:
To evaluate the operational conditions of crash carts in all clinical and surgical hospitalization units of public hospitals in a region in Southern Brazil.
Method:
Quantitative, cross-sectional study to evaluate crash carts in adult clinical and surgical hospitalization units. The data were collected through a checklist containing 16 continuous variables.
Results:
Nineteen crash carts in nineteen units were evaluated. Analysis shows that the most frequent problems were excess of equipment and its lack of organization, medication in incorrect compartments and/or with no identification, and inappropriate environment for transportation.
Conclusion:
The most relevant factors that possibly interfere with the operational conditions of crash carts are directly related to the organization and management of material resources, which may lead to the reduction of its functionality during patient care. Such problem may be solved by readjusting items and performing frequent verification.
... 2 In another study the Pennsylvania Patient Safety Authority identi ed 56 reports over the course of a 12-month reporting period of 2008 speci cally related to emergency equipment; 35 reports referenced issues with emergency carts and 21 reports referenced issues with missing supplies or malfunctioning equipment during an emergency situation. 3 Show all authorsAndrew MayerIn a similar study conducted by Capt (Brig) Akash Raj et al, publishedin February 2019, it was observed that none of the hospitals in the study followed the standard checklist for resuscitation cart.4 ...
Background:
The equipment and medications that would be required to treat a patient in the first thirty minutes or so of a medical emergency are stored in resuscitation cart. There was no standardization of resuscitation cart as observed during ward rounds in our super specialty hospital. Hence the study was conducted with an aim of streamlining the contents of the resuscitation cart and to develop a policy for its maintenance.
Materials & Methods:
The study was conducted in all the patient care areas of the super specialty hospital. Resuscitation cart policy and checklist were developed by seeking inputs from all the stakeholders and validating the same using the available literature. A training program was conducted and a total of 13 resuscitation carts were inspected against the approved checklist for checking its contents in both pre and post intervention periods.
Results: Resuscitation cart policy and checklist were prepared, validated by the domain experts and implemented. The compliance of all 13 resuscitation cart in terms of their contents increased from 77.82% to 97.87% with p value of <0.05 which is statistically significant.
Conclusion:
Maintaining resuscitation carts as per the checklist is a continuous process which will contribute to patient safety.
Difficult vascular access (DVA) is a potentially life-threatening condition that can prevent the delivery of efficient and effective medical care for at-risk patients. Under emergent conditions, DVA can delay the resuscitation of unstable patients by complicating providers’ efforts to administer life-saving fluids and medications. Improved awareness of the causes of DVA, including strategies to overcome these factors, may help to minimize the sequelae of DVA. This chapter proposes four main factors influencing the development of DVA, as well as solutions for DVA management in the emergent setting, based upon established techniques and evidence-based guidelines.
