The "Resus:Station": the use of clinical simulations in a randomised crossover study to evaluate a novel resuscitation trolley.
OBJECTIVE
Inadequately designed equipment has been implicated in poor efficiency and critical incidents associated with resuscitation. A novel resuscitation trolley (Resus:Station) was designed and evaluated for impact on team efficiency, user opinion, and teamwork, compared with the standard trolley, in simulated cardiac arrest scenarios.


METHODS
Fifteen experienced cardiac arrest teams were recruited (45 participants). Teams performed recorded resuscitation simulations using new and conventional trolleys, with order of use randomised. After each simulation, efficiency ("time to drugs", un-locatable equipment, unnecessary drawer opening) and team performance (OSCAR) were assessed from the video recordings and participants were asked to complete questionnaires scoring various aspects of the trolley on a Likert scale.


RESULTS
Time to locate the drugs was significantly faster (p=0.001) when using the Resus:Station (mean 5.19s (SD 3.34)) than when using the standard trolley (26.81s (SD16.05)). There were no reports of missing equipment when using the Resus:Station. However, during four of the fifteen study sessions using the standard trolley participants were unable to find equipment, with an average of 6.75 unnecessary drawer openings per simulation. User feedback results clearly indicated a highly significant preference for the newly designed Resus:Station for all aspects. Teams performed equally well for all dimensions of team performance using both trolleys, despite it being their first exposure to the Resus:Station.


CONCLUSIONS
We conclude that in this simulated environment, the new design of trolley is safe to use, and has the potential to improve efficiency at a resuscitation attempt.
Clinical Safety Research Unit, Department of Surgery & Cancer, Imperial College London, 10th Floor QEQM Building, St Mary's Hospital, Praed Street, London W2 1NY, UK. susanna.walker@imperial.ac.uk
Susanna T
ST
Walker
Stephen J
SJ
Brett
Anthony
A
McKay
Rajesh
R
Aggarwal
Charles
C
Vincent
D018592:Cross-Over Studies; D004867:Equipment Design; D006801:Humans; D016544:Patient Simulation; D012151:Resuscitation / Q000295:instrumentation*; D011795:Surveys and Questionnaires