Aim 
Successful in-hospital cardiopulmonary resuscitation requires well-equipped emergency carts and properly functioning equipment. This audit cycle aimed to reveal, and correct, any shortcomings related to the adequacy of emergency carts within Mater Dei Hospital, Malta.

Methods
 A quantitative, descriptive research design was used to audit contents of the carts. We addressed 45 emergency carts chosen at random in 2017. Data collection focused on surveillance and equipment as outlined by the standard operating procedure (SOP) [1]. A new SOP [2] was issued following the results of the first audit cycle. The SOP detailed significant changes to the carts including pre-packed trays and focused on ward autonomy. A re-audit was performed in August 2020.

Results 
Cart adequacy was assessed according to six criteria defined in Figure 1. There was a significant improvement following the introduction of the new SOP with all categories reaching statistical significance except consumables [17.80% of carts were found inadequate during 1st audit cycle vs 7.50% in the re-audit (p=0.0735)] and emergency drugs [33.30% vs 30% (p=0.3632)]. The remaining categories registered a statistically significant improvement with p values <0.0001 in airway and breathing (73% vs 17.50%), circulation (55.60% vs 17.50%) and fluids tray (75.60% vs 10%).

Discussion 
The first audit cycle highlighted significant malpractice with regards to emergency cart maintenance. Focus of the new SOP was on pre-packed trays aimed at standardising equipment across all wards and reducing unnecessary items. Wards were allowed more autonomy particularly with respect to fluids. We believe the new SOP has improved the standard of emergency carts significantly.

References
Esposito T, Emergency Cart Check and Replenish System. Standard Operating Procedure Version 01.5. 2015
Briffa D. Emergency Trolley Care. Standard Operating Procedure Version 1.0. 2018
Figure 1 - Bar Chart showing the percentage of inadequate emergency carts during the first and second audit cycle

Aim 
Successful in-hospital cardiopulmonary resuscitation requires well-equipped emergency carts and properly functioning equipment. This audit cycle aimed to reveal, and correct, any shortcomings related to the adequacy of emergency carts within Mater Dei Hospital, Malta.

Methods
 A quantitative, descriptive research design was used to audit contents of the carts. We addressed 45 emergency carts chosen at random in 2017. Data collection focused on surveillance and equipment as outlined by the standard operating procedure (SOP) [1]. A new SOP [2] was issued following the results of the first audit cycle. The SOP detailed significant changes to the carts including pre-packed trays and focused on ward autonomy. A re-audit was performed in August 2020.

Results 
Cart adequacy was assessed according to six criteria defined in Figure 1. There was a significant improvement following the introduction of the new SOP with all categories reaching statistical significance except consumables [17.80% of carts were found inadequate during 1st audit cycle vs 7.50% in the re-audit (p=0.0735)] and emergency drugs [33.30% vs 30% (p=0.3632)]. The remaining categories registered a statistically significant improvement with p values <0.0001 in airway and breathing (73% vs 17.50%), circulation (55.60% vs 17.50%) and fluids tray (75.60% vs 10%).

Discussion 
The first audit cycle highlighted significant malpractice with regards to emergency cart maintenance. Focus of the new SOP was on pre-packed trays aimed at standardising equipment across all wards and reducing unnecessary items. Wards were allowed more autonomy particularly with respect to fluids. We believe the new SOP has improved the standard of emergency carts significantly.

References
1. Esposito T, Emergency Cart Check and Replenish System. Standard Operating Procedure Version 01.5. 2015
2. Briffa D. Emergency Trolley Care. Standard Operating Procedure Version 1.0. 2018
Figure 1 - Bar Chart showing the percentage of inadequate emergency carts during the first and second audit cycle

An audit cycle aimed at improving emergency cart standards in an acute teaching hospital

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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