Study of Compliance of Management of Crash Carts to Standards in the Emergency of a Tertiary Care Teaching Hospital

Abstract

To conduct a gap analysis of crash carts in a tertiary care teaching hospital's emergency department by comparing the salient crash cart parameters to standards listed by the Resuscitation Council UK (for equipment) and the National Accreditation Board of Hospitals and Health Care Providers (for management of medication). Additionally, to evaluate the improvement in compliance with the simple intervention of educating staff on protocol. A descriptive, quantitative, observational study, supplemented in the second phase by an intervention to raise staff awareness of the importance of standardisation, followed by an assessment of the level of improvement in compliance to standards in terms of cart content, labelling, documentation, and functionality. The management of the carts is a clinico-administrative issue; standardization of the carts is expected in all areas of the emergency.The root causes of non-compliance with standardisation were the design of the area and the various types of crash carts used, the amount of workload, which resulted in the neglect of labelling, and documentation protocols, which resulted in decreased accountability and inefficient monitoring. This has an influence on the crash carts' ability to provide sufficient content and functionality. The customisation of crash carts for cognitive ergonomic design, as well as the clarity and understanding of the criteria among the nursing staff, or "first responder," went a long way in enhancing compliance with standards. The use of sub-trolleys, human factor engineering, raising understanding of standard protocols, and enhancing sensitivity can all work together to ensure that crash carts perform effectively in an emergency.