title: A simple solution for improving reliability of cardiac arrest equipment provision in hospital.
abstract: BACKGROUND
  Effective and safe cardiac arrest care in the hospital setting is reliant on the immediate availability of emergency equipment. The patient safety literature highlights deficiencies in current approaches to resuscitation equipment provision, highlighting the need for innovative solutions to this problem.
  
  
  METHODS
  We conducted a before-after study at a large NHS trust to evaluate the effect of a sealed tray system and database on resuscitation equipment provision. The system was evaluated by a series of unannounced inspections to assess resuscitation trolley compliance with local policy prior to and following system implementation. The time taken to check trolleys was assessed by timing clinicians checking both types of trolley in a simulation setting.
  
  
  RESULTS
  The sealed tray system was implemented in 2010, and led to a significant increase in the number of resuscitation trolleys without missing, surplus, or expired items (2009: n=1 (4.76%) vs 2011: n=37 (100%), p<0.001). It also significantly reduced the time required to check each resuscitation trolley in the simulation setting (12.86 (95% CI: 10.02-15.71) vs 3.15 (95% CI: 1.19-4.51)min, p<0.001), but had no effect on the number of resuscitation trolleys checked every day over the previous month (2009: n=8 (38.10%) vs 2011: n=11 (29.73%), p=0.514).
  
  
  CONCLUSIONS
  The implementation of a sealed tray system led to a significant and sustained improvement in resuscitation equipment provision, but had no effect on resuscitation trolley checking frequency.
authors.affiliation: Resuscitation Service, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Davies
authors.affiliation: Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Couper
authors.affiliation: Resuscitation Service, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Bradley
authors.affiliation: Resuscitation Service, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Annalie
authors.initials: A
authors.lastname: Baker
authors.affiliation: Resuscitation Service, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Husselbee
authors.affiliation: Patient Safety Team, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Woolley
authors.affiliation: Resuscitation Service, Heart of England NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Robin P
authors.initials: RP
authors.lastname: Davies
authors.affiliation: Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: g.d.perkins@warwick.ac.uk.
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D016001:Confidence Intervals; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004865:Equipment and Supplies, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D057209:Hospital Rapid Response Team / Q000458:organization & administration; D006801:Humans; D008297:Male; D019026:Medicine Chests; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety; D058996:Quality Improvement; D015203:Reproducibility of Results; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Cardiopulmonary resuscitation; Emergencies; Hospital equipment; Patient safety; Quality improvement