Publication:

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

Background The successful management of cardiopulmonary emergencies revolves around the optimum utilization of the golden hour, so that the patient gets the best possible advantage at survival. Aim of the study was to perform gap analysis of crash carts in the emergency of a tertiary care teaching hospital by comparing the salient parameters with standards listed by Resuscitation Council UK (for equipment) and National Accreditation Board of Hospitals and health care providers (for management of medication). Further, to assess the improvement in compliance with the simple intervention of educating staff regarding protocols.

Methods A descriptive, quantitative, observational study, supplemented in the second phase by an intervention to increase awareness of staff in achieving standardization, followed further by assessing the level of improvement in compliance to standards in terms of content, labeling, documentation and functionality of the contents of the carts.

Results The root causes of non-adherence to standardization were design of the area and of the cart, amount of workload which led to neglect of labelling, documentation protocols resulting in decreased accountability and inefficient monitoring. This impacted the adequate provision of content and functionality of the items in the crash carts. Human factor engineering in the form of customization of crash carts for cognitive ergonomic design, clarity and awareness of guidelines among the nursing staff i.e. ‘first responder’ went a long way in improving compliance to standards.

Conclusions Human factor engineering supplemented by usage of sub-trolleys, along with increasing sensitivity and awareness to standard protocols, can help achieve maximum compliance in terms of the effective functioning of crash carts in the emergency.