Re-stocking the resuscitation trolley: how good is compliance with checking procedures?

Abstract

This study retrospectively reviewed compliance with the checking policy for resuscitation trolleys on medical, surgical and paediatric wards in a large UK city-based teaching hospital. Successful advanced life support (ALS) relies on the availability of a resuscitation trolley that provides the required equipment and recommended drugs. Missing or faulty equipment can significantly compromise ALS. Local policy stipulates periodic checking, and re-stocking as required, of resuscitation trolleys, and checklists are provided for this purpose. The checklist forms located on each trolley were examined between January and December 2005. The frequency of checking was compared with the arrest calls made within that period. The medical, surgical and paediatric wards had a mean checking rate of 72.2%, 68.8% and 65.9%, respectively. In December one ward checked their trolley on 11/31 (35.5%) days of the month, during which there were two cardiac arrest calls. In this hospital, basic trolley checking procedures are not being followed, leaving the trolley unchecked, and possibly unprepared, for an emergency cardiopulmonary arrest. Hospitals should regularly review compliance with policies and procedures for the checking of resuscitation equipment to ensure that appropriate and functioning equipment, and unexpired drugs are in place in all clinical areas.

Assessment of cardiopulmonary resuscitation equipment in resuscitation trolleys in district hospitals in Botswana: A cross-sectional study

“…Deficiencies in the availability and the maintenance of resuscitation equipment have been widely reported in the literature. 7,9 Studies conducted in various African countries (Botswana, 10 Ghana, 11 Kenya, 12 Namibia 13 and South Africa 14 ) as well as Asia (Thailand, 15 India 16 ), the United Kingdom 17 and the United States 18 indicate that the non-availability of equipment and drugs in the resuscitation trolley causes delay in initiating CPR.…”

Using Failure Mode and Effects Analysis to identify hazards within resuscitation

“…This FMEA and our previous study [33] highlighted that missing equipment was a probable occurrence, to overcome this the design team suggested fitting the trolley and equipment with a Radio Frequency IDentification (RFID) tagging system that can alert staff if equipment is missing. Another important feature was to clearly display equipment in a standardised layout which is easily accessible to staff during resuscitation but can be hidden away using a drop-down blind system when the trolley is not in use, to avoid equipment being taken.…”

Study of compliance of crash carts to standards in the emergency of a tertiary care teaching hospital

“…28 In this study, the compliance to a system of regular checks of functionality of equipment, as shown in various studies was successfully implemented by proper, supervised documentation. 27,29,30 However, it needs to be stressed through this study, that the technical staff responsible for the functionality of equipment is generally posted on on-call basis, but this parameter should be implemented through the local senior nursing staff of the area who are stationed in the area itself. The protocol for displaying standard checklist with a list of compulsory equipment and drugs to be displayed on the trolley to assist in -systematic, visual and functional testing‖ improved significantly postintervention.…”